Adherence to Oral Disease Modifying Therapies in Clinical Practice and Patient-Centered Outcomes

Background: There are more than 20 disease modifying therapies (DMTs) approved for treatment of Multiple Sclerosis. Previous studies in the same population cohort, treated with self-injectable medication reported only 68% of patients continued to stay on treatment over a 2-year period. Only a few studies have evaluated adherence to oral DMTs among patients with MS, and they have mainly focused on the effect of one specific agent or using pharmacy claims. Non-adherence to therapy may reduce the effectiveness of those agents and affect quality of life and progression of disease.

Objectives: To examine adherence to oral disease modifying therapies and patient-centered outcomes using patient’s reported data

Methods: The study population consisted of 300 patients with MS followed in a large health care system. Patient’s mailed surveys were used to compile data on medication adherence to fingolimod, dimethyl fumarate, teriflunomide, the patient factors associated with medication adherence and quality of life (MSQLI). Descriptive statistics were used to summarize the data.

Results: 41 patients responded to the survey out of which 33 (80%) were female, 28(68%) were white. Median age was 52 and median disease duration was 13.5 years. 31 (79%) reported 100% adherence to medication, 7(18%) reported 90% adherence. 50% of patient reported side effects to medication, but 83% of them reported minimal or no interference with physical health because of the side effects. Majority (30) felt that their general health was at least good and 29 (70%) reported being stable. 30% did not expect their health to worsen and 29% did not know what to expect, however 85% felt satisfied with their current treatment.

Conclusions: In clinical practice, self-reported adherence to oral DMTs is higher than adherence reported with self-injections.