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Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems

Sarah Thomason Orcid Logo, Nima Moghaddam, Nikos Evangelou, Rod Middleton Orcid Logo, Roshan das Nair Orcid Logo

Multiple Sclerosis and Related Disorders, Volume: 88, Start page: 105727

Swansea University Author: Rod Middleton Orcid Logo

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DOI (Published version): 10.1016/j.msard.2024.105727

Abstract

BackgroundAdherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence.ObjectivesTo investigate...

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Published in: Multiple Sclerosis and Related Disorders
ISSN: 2211-0348
Published: Elsevier BV 2024
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URI: https://cronfa.swan.ac.uk/Record/cronfa68037
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first_indexed 2024-10-22T12:23:08Z
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spelling v2 68037 2024-10-22 Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems 005518f819ef1a2a13fdf438529bdfcd 0000-0002-2130-4420 Rod Middleton Rod Middleton true false 2024-10-22 MEDS BackgroundAdherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence.ObjectivesTo investigate prevalence of and barriers to adherence, including for people with MS-related cognitive problems, and to identify adherence-related strategies.MethodsRecruited via the UK MS Register and MS Society groups, participants completed a Medication Adherence Questionnaire and the Perceived Deficits Questionnaire. A subset were interviewed.Results: Of 257 participants, 94 % reported being adherent, although 59 % missed ≥1 dose, and 25 % reported cognitive problems. Adherence was lower amongst those with cognitive problems, who experienced more barriers: memory problems; negative feelings about taking medication; and not wanting medication to interfere with activities. Such barriers, along with mood, cognition, and method of DMT administration, explained 17 % of variance in adherence, with intravenous treatment a significant predictor. Cognitive problems explained a unique proportion of variance; however, was non-significant when anxiety was factored in. Interviews highlighted how anxiety about side-effects and injections, and difficulties accepting the diagnosis, hindered use of reminders.ConclusionInterventions for cognition and mood problems, minimising treatment burden and supporting adjustment to diagnosis, may improve adherence. Journal Article Multiple Sclerosis and Related Disorders 88 105727 Elsevier BV 2211-0348 1 8 2024 2024-08-01 10.1016/j.msard.2024.105727 http://dx.doi.org/10.1016/j.msard.2024.105727 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee MS Society 2024-10-22T13:23:10.3024668 2024-10-22T13:20:09.5273782 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Sarah Thomason 0000-0003-4296-3668 1 Nima Moghaddam 2 Nikos Evangelou 3 Rod Middleton 0000-0002-2130-4420 4 Roshan das Nair 0000-0001-8143-7893 5 285 Rod Middleton 0000-0002-2130-4420 r.m.middleton@swansea.ac.uk false 4
title Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
spellingShingle Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
Rod Middleton
title_short Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
title_full Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
title_fullStr Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
title_full_unstemmed Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
title_sort Barriers and strategies to medication adherence amongst people with multiple sclerosis and cognitive problems
author_id_str_mv 005518f819ef1a2a13fdf438529bdfcd
author_id_fullname_str_mv 005518f819ef1a2a13fdf438529bdfcd_***_Rod Middleton
author Rod Middleton
author2 Sarah Thomason
Nima Moghaddam
Nikos Evangelou
Rod Middleton
Roshan das Nair
format Journal article
container_title Multiple Sclerosis and Related Disorders
container_volume 88
container_start_page 105727
publishDate 2024
institution Swansea University
issn 2211-0348
doi_str_mv 10.1016/j.msard.2024.105727
publisher Elsevier BV
college_str Faculty of Medicine, Health and Life Sciences
hierarchytype
hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
url http://dx.doi.org/10.1016/j.msard.2024.105727
document_store_str 0
active_str 0
description BackgroundAdherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence.ObjectivesTo investigate prevalence of and barriers to adherence, including for people with MS-related cognitive problems, and to identify adherence-related strategies.MethodsRecruited via the UK MS Register and MS Society groups, participants completed a Medication Adherence Questionnaire and the Perceived Deficits Questionnaire. A subset were interviewed.Results: Of 257 participants, 94 % reported being adherent, although 59 % missed ≥1 dose, and 25 % reported cognitive problems. Adherence was lower amongst those with cognitive problems, who experienced more barriers: memory problems; negative feelings about taking medication; and not wanting medication to interfere with activities. Such barriers, along with mood, cognition, and method of DMT administration, explained 17 % of variance in adherence, with intravenous treatment a significant predictor. Cognitive problems explained a unique proportion of variance; however, was non-significant when anxiety was factored in. Interviews highlighted how anxiety about side-effects and injections, and difficulties accepting the diagnosis, hindered use of reminders.ConclusionInterventions for cognition and mood problems, minimising treatment burden and supporting adjustment to diagnosis, may improve adherence.
published_date 2024-08-01T13:23:08Z
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score 11.037166

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