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Preferences, adherence, and satisfaction: three years of treatment experiences of people with multiple sclerosis

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Item Type:Article
Title:Preferences, adherence, and satisfaction: three years of treatment experiences of people with multiple sclerosis
Creators Name:Hoffmann, O. and Paul, F. and Haase, R. and Kern, R. and Ziemssen, T.
Abstract:BACKGROUND: To reduce the risk of long-term disability in people with Multiple Sclerosis (pwMS), an increasing number of disease-modifying immune therapies (DMT) are available, involving diverse mechanisms of action, levels of efficacy, treatment risks, and tolerability aspects. Including patient preferences and expectations in shared decision-making may improve treatment satisfaction, adherence, and persistence. PURPOSE: To investigate long-term alignment of individual preferences and expectations of pwMS with their actual DMT and its effect on treatment satisfaction, health-related quality of life (HRQoL), adherence, and treatment discontinuation. METHODS: A total of 401 pwMS beginning a new DMT were enrolled from 2015 to 2018 in a non-interventional study at three German MS centres. Patient preferences regarding DMT, TSQM-9, SF36, and self-reported adherence as well as relapses and EDSS were recorded at baseline and every 3 to 6 months for up to 3 years. RESULTS: Efficacy and tolerability were the highest-ranking preferences at baseline. Actual selection of DMT corresponded more closely to safety than efficacy, tolerability, or convenience preferences. Participants reported excellent adherence throughout the study. DMT persistence was 69.0%, with earlier discontinuation for injectable vs oral or infusion therapies. Breakthrough disease, rather than patient-reported outcomes, was the main driver of DMT discontinuation. For all routes of administration, global treatment satisfaction increased over time despite lower satisfaction with convenience. Several patterns of changing preferences were observed. CONCLUSION: This study provides insight into the interaction of DMT preferences of pwMS with their actual treatment experience. Treatment decisions should be aligned with long-term expectations of pwMS to promote continuous adherence.
Keywords:Multiple Sclerosis, Treatment Adherence and Compliance, Treatment Discontinuation, Patient Preference, Health-Related Quality of Life
Source:Patient preference and adherence
Publisher:Dove Medical Press Ltd
Page Range:455-466
Date:22 February 2024
Official Publication:https://doi.org/10.2147/ppa.s452849
PubMed:View item in PubMed

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