Medication Adherence in Patients With Multiple Sclerosis

Also on the agenda for day one at the Academy of Managed Care Pharmacy (AMCP) 24th Annual Meeting in San Francisco was a satellite symposium that focused on analyzing and applying evidence to improve the cost/benefit and risk/benefit outcomes in multiple sclerosis (MS). One of the overarching themes throughout the 5 presentations that comprised the program was medication adherence.

There are many reasons why patient compliance and adherence can become problematic throughout the course of treatment for MS. Some of the reasons that presenters discussed included patients’ level of disability; curiosity about new modes of administration and other therapies; financial issues; injection fatigue; lack of support systems; and perceived lack of efficacy. And while lack of medication adherence leads to complications for patients being treated for all disease states, patients with MS in particular seem to have problems with adherence. In fact, 31% of patients with MS polled in a recent study have reported taking a deliberate break from treatment for one or more days. Even worse, 19% reported that they had stopped taking their MS treatment completely.

It is evident that patients with MS face many potential factors that could decrease their medication adherence. So what can be done? Healthcare providers can only do so much — changing therapies and encouraging patients to stick with a regimen does not work for all patients. The discussion in the session at one point turned to the potential of oral MS agents to improve adherence. The perception that they are better tolerated and the fact that this type of treatment is less invasive to daily activities could help patients adhere to the medication. However, the perception that this type of treatment is less effective must be considered as well.

Currently, MS treatments are long-term treatments that are often very costly and contain serious side effects. Considering that successful outcomes for patients require lifetime adherence and disease management, it is no surprise that many patients fail to adhere to their therapies at one time or another. However, there is hope that improving therapies by way of pharmacogenomics will not only improve therapies (and therefore the outlook of patients) but will also, in time, result in more affordable treatment. A recent genome-wide association study of 9722 cases from 15 countries identified 29 novel risk loci and multiple variants with roles in disease susceptibility. Researchers have also found that risk genes are often shared with other immunological disorders, such as type 1 diabetes and rheumatoid arthritis. As personalized medicine continues to help improve MS therapies, it should be expected that medication adherence rates for patients with MS will improve along with therapies.

For more infomation regarding the AMCP 24th Annual Meeting, please visit www.amcp.org.