Video abstract
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Background
Treatment of multiple sclerosis (MS) with disease-modifying drugs (DMDs) can reduce relapse frequency and delay disability progression. Although adherence to DMDs is difficult to measure accurately, evidence suggests that poor adherence is common and can compromise treatment success. There are likely to be multiple factors underlying poor adherence. To better understand these factors, the global MS Choices Survey investigated patient and physician perspectives regarding key aspects of MS diagnosis, treatment adherence and persistence, and disease management.
Methods
The survey was conducted in seven countries and involved patients with MS (age 18–60 years; MS diagnosis for ≥1 year; current treatment with a DMD) and physicians (neurologist for 3–30 years; treating ≥15 patients with MS per average month; >60% of time spent in clinical practice). Separate questionnaires were used for physicians and patients, each containing approximately 30 questions.
Results
Questionnaires were completed by 331 patients and 280 physicians. Several differences were observed between the responses of patients and physicians, particularly for questions relating to treatment adherence. Overall, the proportion of patients reporting taking a treatment break (31%) was almost twice that estimated by physicians (on average 17%). The reasons cited for poor adherence also differed between patients and physicians. For example, more physicians cited side effects as the main reason for poor patient adherence (82%), than responding patients (42%).
Conclusions
Physicians may underestimate the scale of poor adherence to DMDs, which could impact on their assessment of treatment efficacy and result in inappropriate treatment escalation. In addition, disparities were identified between patient and physician responses regarding the underlying reasons for poor adherence. Improvements in the dialog between patients and neurologists may increase adherence to DMDs.
Supplementary materials
Table S1 Questions included in physicians’ questionnaire
Table S2 Questions included in patients’ questionnaire
Acknowledgments
The authors thank Steve Smith and Anna Palagyi of Caudex Medical Ltd, Oxford, UK (supported by Merck Serono S.A. – Geneva, Switzerland, a branch of Merck Serono S.A., Coinsins, Switzerland, an aff iliate of Merck KGaA, Darmstadt, Germany), for assistance with the preparation of the initial draft of the manuscript and for collating input from all authors (SS), and for editing for English and assistance with preparation for submission (AP).
Disclosure
This study was commissioned and supported by Merck Serono S.A. – Geneva, Switzerland, a branch of Merck Serono S.A., Coinsins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany, with research conducted by GfK Healthcare, London, UK. AR and EV are employees of Merck Serono S.A. – Geneva, Switzerland, a branch of Merck Serono S.A., Coinsins, Switzerland, an affiliate of Merck KGaA, Darmstadt, Germany. MB and DH are employees of GfK Healthcare, London, UK.