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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 and Tomáš DOLEŽAL. Relationship between Patient Preferences, Attitudes to Treatment, Adherence, and Quality of Life in New Users of Teriflunomide. \textit{Pharmaceuticals}. Basel: MDPI, 2022, vol.~15, No~10, p.~1-12. ISSN~1424-8247. Available from: https://dx.doi.org/10.3390/ph15101248.
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