Psychosocial predictors of patient adherence to disease-modifying therapies for multiple sclerosis

Figures & data

Table 1 Study participant characteristics

Participant characteristics
Sex (female)*	133 (81.6%)
Education (bachelor degree or higher)	102 (62.6%)
Relationship status (married)*	84 (51.5%)
Employment (employed)*	62 (38%)
Additional chronic medical condition	50 (30.7%)
Duration of MS (years)	6.39±3.97
DMT type
Interferon-beta	122 (74.8%)
Natalizumab	9 (5.5%)
Fingolimod	6 (3.7%)
Teriflunomide	1 (0.61%)
Other	25 (15.3%)
Family history of MS	31 (19.0%)
Adherence on VAS (%)	79.47±25.26
Supernatural belief	85 (52.1%)
Past history of psychiatric illness	8 (4.9%)
PHQ9	9.67±6.52
GAD7	8.37±5.73
PHQ15	10.60±5.65
ECR-16 anxious	33.79± 11.30
ECR-16 avoidance	23.57±9.54
MOCA	20.23±4.66

Notes:

* Data listed as frequency (%); all other data listed as mean ± standard deviation. Married included common law; however, no participants were in a common-law relationship. Supernatural belief represents patients’ belief that MS is due to supernatural reasons like magic, possession, and/or an “evil eye”.

Abbreviations: MS, multiple sclerosis; DMT, disease-modifying treatment; VAS, visual analog scale; PHQ9, Patient Health Questionnaire-9; GAD7, Generalized Anxiety Disorder 7-item scale; PHQ15, Patient Health Questionnaire-15; ECR16, Experiences in Close Relationships 16-item scale; MOCA, Montreal Cognitive Assessment.

Table 2 Univariate analysis examining relationship between variables and VAS treatment adherence

Variables	Beta	Standard error	P-value
Age	0.08	0.22	0.71
Sex (female vs male)	−4.94	5.11	0.34
Disease duration	−0.50	0.51	0.32
PHQ9	−0.71	0.30	0.02
GAD7	−1.01	0.32	<0.01
ECR-Anx	−0.33	0.17	0.06
ECR-Avoid	−0.47	0.21	0.02
Family history of MS	−9.31	5.00	0.06
Supernatural belief	−13.92	3.82	<0.01
Past psychiatric illness	3.84	9.18	0.68
Marital status (married vs not married)	1.31	3.97	0.74
Education (bachelor or higher vs lower than bachelor degree)	−5.27	4.10	0.20
Employment status (unemployed vs employed)	5.40	4.07	0.19
MOCA score	0.06	0.43	0.89

Abbreviations: VAS, visual analog scale; PHQ9, Patient Health Questionnaire-9; GAD7, Generalized Anxiety Disorder 7-item scale; ECR-Anx Experiences in Close Relationships total anxious; ECR-Avoid, Experiences in Close Relationships total avoidant; MOCA, Montreal Cognitive Assessment; MS, multiple sclerosis.

Table 3 Multivariate regression analysis examining relationship between variables and VAs treatment adherence

Variable	Estimate	Standard error	P-value
Age	0.02	0.22	0.94
Sex (female vs male)	−1.88	5.02	0.71
PHQ9	−0.51	0.35	0.15
GAD7	−0.66	0.44	0.14
ECR-Anx	−0.01	0.20	0.97
ECR-Avoid	−0.26	0.21	0.22
Family history of MS	−9.61	4.92	0.05
Supernatural belief	−11.41	4.00	<0.01

Abbreviations: VAS, visual analog scale; PHQ9, Patient Health Questionnaire-9; GAD7, Generalized Anxiety Disorder 7-item scale; ECR-Anx, Experiences in Close Relationships total anxious; ECR-Avoid, Experiences in Close Relationships total avoidant; MS, multiple sclerosis.