PDF(Pubmed)
Abstract：
Despite the proven efficacy of the disease-modifying therapy (DMT) for multiple sclerosis (MS), the rates of non-adherence are frequently high. We aimed to evaluate the rate of non-adherence to the first DMT in Upper Egypt and identify different contributing factors. Out of 310 patients, ninety-seven adult patients with RRMS were recruited from three MS units located in Upper Egypt and were subjected to the following: complete clinical history, expanded disability status score (EDSS), Eight-item Morisky Medication Adherence Scale (MMAS-8), abbreviated Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9), Hamilton depression scale, Fatigue Severity Scale (FSS) and the Pittsburgh Sleep Quality Index (PSQI). According to MMAS-8 scores, 63 (64.9%) of patients were non-adherent to their first DMT. Non-adherent patients are more likely to have longer disease duration (p = 0.002), longer duration on first DMT (p = 0.030), first DMT-start date before 2019 (p = 0.040), and lower treatment satisfaction scores (p = 0.016). However, there was no significant relation with physical disability, depression, fatigue, or sleep quality. On the regression analysis model, a lower treatment satisfaction score was the only predictor of DMT non-adherence (p = 0.012). Despite expanding DMT options, non-adherence among MS patients in Upper Egypt is high. Treatment satisfaction with DMT is the only predictor of adherence among MS patients of Upper Egypt. Adherence and satisfaction with the prescribed DMT should be assessed carefully to maximize DMT benefits.
摘要：
尽管疾病改善疗法（DMT）对多发性硬化症（MS）的疗效已得到证实，不依从率通常很高。我们旨在评估上埃及首次DMT的不依从率，并确定不同的影响因素。在310名患者中，97名RRMS成年患者从位于上埃及的三个MS单位招募，并接受以下治疗：完整的临床病史，扩展残疾状况评分(EDSS)，八项Morisky药物依从性量表（MMAS-8），药物治疗满意度简明问卷-9(TSQM-9)，汉密尔顿抑郁量表，疲劳严重程度量表（FSS）和匹兹堡睡眠质量指数（PSQI）。根据MMAS-8评分,63(64.9%)的患者未粘附于他们的第一次DMT。非粘附患者更有可能有更长的疾病持续时间（p=0.002），第一次DMT持续时间更长(p=0.030)，2019年之前的第一个DMT开始日期（p=0.040），治疗满意度得分较低（p=0.016）。然而,与身体残疾没有显著关系，抑郁症,疲劳,或睡眠质量。在回归分析模型上，较低的治疗满意度评分是DMT不依从性的唯一预测因子(p=0.012).尽管增加了DMT选项，上埃及MS患者的不依从性很高.对DMT的治疗满意度是上埃及MS患者依从性的唯一预测指标。应仔细评估对规定DMT的坚持和满意度，以最大限度地提高DMT的效益。
