Challenge

They say that what you don’t know can’t hurt you. But in medicine, what you don’t take can’t help you. In the age of patient centricity, this is especially troubling, as poor medication adherence is severely compromising the benefits of medicine – with only 50 percent of patients with chronic diseases in developed countries adhering to recommended treatments.

With limited data available on the real-world adherence to multiple sclerosis (MS) therapies, a leading global pharmaceutical company wanted to determine the key patient-related, therapy-related and healthcare-provider-related factors that contribute to low medication adherence in the real world.

In addition, the company wanted to evaluate patient adherence rates for the approved disease modifying-therapies (DMTs) for relapsing-remitting MS (RRMS). The company engaged Cerner Enviza, a leader in patient-centric research.

Approach

Through the Global Adherence Project (GAP) – “A Multicenter Observational Study on Adherence to Disease Modifying Therapies in Patients Suffering from Relapsing-Remitting Multiple Sclerosis” – 2,600 patients at 170 sites in 22 countries were profiled using electronic data capture and paper-based surveys. Cerner Enviza conducted a Physician Survey, which provided insight and information about infrastructure, the role of nurses, treatment paradigms and multiple patient adherence factors, as well as a Patient Survey, which gathered valuable information about demographics, social support structures, education on MS and DMTs, and personal views on medical management, quality of life, reasons for non-adherence and complications.

Insight

Results indicated that half of patients were “forgetting to administer injections” and this was the most commonly cited reason for non-adherence. “Forgetting to administer injections” is related to the complexity of treatment regimens or lower cognitive function in non-adherent patients. In addition, 32 percent of non-adherent patients reported at least one of the following injection-related reasons for non-adherence: being tired of taking injections, pain at injection site, injection anxiety, skin reaction, not feeling need for injection, and not having someone available to administer injection.

Impact

The findings confirmed that medication adherence is an issue in MS, and that there are therapy-related factors that physicians and patients should consider when selecting a therapy to facilitate adherence.