Treatment Adherence in Multiple Sclerosis: The Effect of Drug Administration Methods and Neuropsychiatric Comorbidities

Abstract

Objectives: Multiple sclerosis (MS) is a chronic neurodegenerative disease affecting young adults. While disease-modifying drugs (DMDs) help manage and decelerate disease progression, adherence to these treatments is a significant challenge. This study aimed to investigate the relationship between treatment adherence and different drug administration methods in MS patients in the context of neuropsychiatric evaluations. Methods: A prospective cohort study was conducted at the University Hospital of Neurology Clinic using the 2017 revised McDonald criteria for MS diagnosis. Demographic data, MS-related metrics, and DMDs were recorded. Participants were stratified based on their DMDs into oral, injectable, and infusion treatments. The MS Treatment Adherence Questionnaire, Beck Depression Inventory, and State-Trait Anxiety Inventory were administered. Results: Of the 89 patients, treatment adherence was 45%. There were significant differences in side effect scores between the non-adherent and adherent groups for both oral and injectable DMDs. The Beck Depression Inventory average score was 12.49±9.81, while the State-Trait Anxiety Inventory average scores for STAI1 and STAI2 were 38.95±10.41 and 47.89±10.66, respectively. Significant differences were observed in disease duration, the average expanded disability status scale score, and the average STAI score. Conclusion: Adherence rates varied with the method of drug administration, with oral treatments having 34.4% adherence and injectable treatments having 53.4%. Factors like perceived efficacy, depression, and anxiety influenced treatment adherence. No significant correlations were found between demographic factors like age, gender, or education and adherence rates. Treatment adherence is crucial in managing MS. This study highlights the role of drug administration methods and neuropsychiatric comorbidities in influencing adherence. A comprehensive assessment considering these factors is vital in choosing an appropriate DMD for MS patients