The Global Adherence Project (GAP): a multicenter observational study on adherence to disease-modifying therapies in patients with relapsing-remitting multiple sclerosis
The Global Adherence Project (GAP): a multicenter observational study on adherence to disease-modifying therapies in patients with relapsing-remitting multiple sclerosis
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DOI：
10.1111/j.1468-1331.2010.03110.x
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发表时间：
2011-01-01
影响因子：
5.1
通讯作者：
Kieseier, B. C.
中科院分区：
文献类型：
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作者：
Devonshire, V.;Lapierre, Y.;Kieseier, B. C.
背景：多发性硬化症（MS）的大多数疾病修饰疗法（DMT）是自我注射药物，必须持续服用以减少疾病活动。因此，坚持治疗成为一个重要的挑战，必须解决，以最大限度地提高治疗的好处。本研究评价了复发缓解型MS患者对处方治疗的依从性，并探讨了影响依从性的因素。方法：这是一项观察性、多中心、多国、4期研究。患者和医生收到了关于研究时批准的DMT依从性的纸质问卷，包括肌内干扰素β-1a（IFN β-1a）、皮下IFN β-1a、IFN β-1b和醋酸格拉替雷。生活质量和认知数据也被收集。进行多变量分析，以确定与坚持长期DMTs.Results相关的因素：二千六百四十八例患者进行了研究，揭示了平均治疗时间为31个月。75%的患者（n = 1923）坚持治疗。不依从的最常见原因是忘记注射（50.2%）和其他注射相关原因（32.0%）。与非依从性患者相比，依从性患者的生活质量更好（P < 0.05），神经心理问题更少（P < 0.001）。与非依从性患者相比，依从性患者的疾病持续时间显著缩短（P < 0.001），治疗持续时间显著缩短（P = 0.005）。女性比男性更有可能坚持treatment.Conclusion：确定影响遵守规定的治疗的因素是第一步，在改善MS患者的治疗依从性，从而帮助最大限度地发挥长期DMT的好处。
Background:Most disease-modifying therapies (DMTs) for multiple sclerosis (MS) are self-injectable medications that must be taken on an ongoing basis to reduce disease activity. Thus, adherence to therapy becomes an important challenge that must be addressed to maximize benefits of therapy. This study evaluated rates of adherence to prescribed treatment and explored factors affecting adherence amongst patients with relapsing-remitting MS.Methods:This was an observational, multicenter, multinational, phase 4 study. Patients and physicians received paper questionnaires regarding adherence to DMTs approved at the time of the study, including intramuscular interferon beta-1a (IFN beta-1a), subcutaneous IFN beta-1a, IFN beta-1b, and glatiramer acetate. Quality of life and cognition data also were collected. Multivariate analysis was conducted to identify factors associated with adherence to long-term DMTs.Results:Two thousand six hundred and forty-eight patients were studied, revealing an average treatment duration of 31 months. Seventy-five percent of patients (n = 1923) were adherent to therapy. The most common reasons for non-adherence were forgetting to administer the injection (50.2%) and other injection-related reasons (32.0%). Adherent patients reported better quality of life (P < 0.05) and fewer neuropsychological issues (P < 0.001) than non-adherent patients. Adherent patients had significantly shorter duration of disease (P < 0.001) and shorter duration of therapy (P = 0.005) than non-adherent patients. Women were more likely than men to adhere to treatment.Conclusion:Identifying factors that affect adherence to prescribed treatments is the first step in improving adherence of patients with MS to therapy, thereby helping maximize the benefits of long-term DMTs.