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@article{2251342,
author = {Strosova, Daniela and Tuzil, Jan and Turkova Velackova, Barbora Velackova and Pilnackova Filkova, Barbora and Lzicarova de Souza, Lada and Dolezalova, Helena and Raskova, Michaela and Dufek, Michal and Doležal, Tomáš},
article_location = {Basel},
article_number = {10},
doi = {http://dx.doi.org/10.3390/ph15101248},
keywords = {multiple sclerosis; teriflunomide; adherence; quality of life; MMAS-8; BMQ; SEAMS},
language = {eng},
issn = {1424-8247},
journal = {Pharmaceuticals},
title = {Relationship between Patient Preferences, Attitudes to Treatment, Adherence, and Quality of Life in New Users of Teriflunomide},
url = {https://www.mdpi.com/1424-8247/15/10/1248},
volume = {15},
year = {2022}
}
TY - JOUR
ID - 2251342
AU - Strosova, Daniela - Tuzil, Jan - Turkova Velackova, Barbora Velackova - Pilnackova Filkova, Barbora - Lzicarova de Souza, Lada - Dolezalova, Helena - Raskova, Michaela - Dufek, Michal - Doležal, Tomáš
PY - 2022
TI - Relationship between Patient Preferences, Attitudes to Treatment, Adherence, and Quality of Life in New Users of Teriflunomide
JF - Pharmaceuticals
VL - 15
IS - 10
SP - 1-12
EP - 1-12
PB - MDPI
SN - 14248247
KW - multiple sclerosis
KW - teriflunomide
KW - adherence
KW - quality of life
KW - MMAS-8
KW - BMQ
KW - SEAMS
UR - https://www.mdpi.com/1424-8247/15/10/1248
N2 - Background: A poor patient adherence often limits the real-world effectiveness of an oral disease-modifying therapy (DMT) for multiple sclerosis (MS). In the present study, we aimed to map patient preferences, attitudes toward treatment, and quality of life to identify the predictors of non-adherence to teriflunomide. Methods: This was a single-arm, non-interventional, multicenter study (Czech Act 378/2007 Coll.) consisting of three visits: the first at treatment initiation (teriflunomide 14 mg), and then after 3 and 9 months of therapy. We enrolled both DMT-naive and patients who had undergone a DMT diagnosed with a clinically isolated syndrome (CIS) or relapsing-remitting multiple sclerosis (RRMS). The functional status and MS activity were estimated using the Expanded Disability Status Scale (EDSS) and annualized relapse rate (ARR); the quality of life via the Multiple Sclerosis Impact Scale (MSIS-29); the medication adherence with the Morisky Medication Adherence Scale (MMAS-8); the confidence in the ability to take medications by the Self-Efficacy for Appropriate Medication Score (SEAMS); and the attitude to the therapy via the Beliefs about Medicines Questionnaire (BMQ). After nine months of therapy, we predicted the adherence to teriflunomide (MMAS-8) by fitting a multivariate ordinal logistic model with EDSS changes, gender, previous DMT, MSIS-29, BMQ, and SEAMS as the explanatory variables. Results: Between 2018 and 2019, 114 patients were enrolled at 10 sites in the Czech Republic. The mean age was 41.2 years, 64.8% were diagnosed with a CIS, 52.4% were DMT-naive, and 98.1% of patients preferred an oral administration at the baseline. The mean EDSS baseline was 1.97 and remained constant during the 9 months of therapy. The ARR baseline was 0.72 and dropped to 0.19 and 0.15 after 3 and 9 months, respectively. Despite a more than 4-fold higher ARR baseline, the treatment-naive patients achieved an ARR at 9 months comparable with those previously treated. There were ten non-serious adverse reactions. After nine months of teriflunomide therapy, 63.3%, 21.2%, and 15.4% of patients had a high, medium, and low adherence, respectively, as per the MMAS-8; 100% of patients preferred an oral administration. The SEAMS score (odds ratio (OR) = 0.91; p = 0.013) and previous DMT (OR = 4.28; p = 0.005) were the only significant predictors of non-adherence. The disability, the quality of life, and beliefs about medicines had no measurable effect on adherence. Conclusion: After nine months of teriflunomide therapy, both the disability and quality of life remained stable; the relapse rate significantly decreased, 63.3% of patients had a high adherence, and 100% of patients preferred an oral administration. A low adherence was associated with previous DMT experiences and a low self-efficacy for the appropriate medication (i.e., the confidence in one's ability to take medication correctly).
ER -
STROSOVA, Daniela, Jan TUZIL, Barbora Velackova TURKOVA VELACKOVA, Barbora PILNACKOVA FILKOVA, Lada LZICAROVA DE SOUZA, Helena DOLEZALOVA, Michaela RASKOVA, Michal DUFEK a Tomáš DOLEŽAL. Relationship between Patient Preferences, Attitudes to Treatment, Adherence, and Quality of Life in New Users of Teriflunomide. \textit{Pharmaceuticals}. Basel: MDPI, 2022, roč.~15, č.~10, s.~1-12. ISSN~1424-8247. Dostupné z: https://dx.doi.org/10.3390/ph15101248.
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