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首页> 外文期刊>Patient Preference and Adherence >An evaluation of adherence in patients with multiple sclerosis newly initiating treatment with a self-injectable or an oral disease-modifying drug
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An evaluation of adherence in patients with multiple sclerosis newly initiating treatment with a self-injectable or an oral disease-modifying drug

机译：新开始使用自注射或口服疾病缓解药物治疗的多发性硬化症患者的依从性评估

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Objective: As the multiple sclerosis (MS) disease-modifying drug (DMD) treatment options have expanded to include oral therapies, it is important to understand whether route of administration is associated with DMD adherence. The objective of this study was to compare adherence to DMDs in patients with MS newly initiating treatment with a self-injectable versus an oral DMD. Methods: This retrospective database study used IMS Health Real World Data Adjudicated Claims – US data between July 1, 2010 and June 30, 2014. Adherence was measured by medication possession ratio (MPR), calculated as the total number of treated days divided by the total number of days from the first treated day until the end of 12-month follow-up. A binary measure representing adherence (MPR ≥0.8) versus nonadherence (MPR <0.8) to therapy was used. Logistic regression evaluated the likelihood of adherence to index DMD type (self-injectable vs oral). Covariates included patient baseline characteristics (ie, age, sex, comorbidities) and index DMD type. Results: The analysis included 7,207 self-injectable and 1,175 oral DMD-treated patients with MS. In unadjusted analyses, the proportion of patients adherent to therapy (MPR ≥0.8) did not differ significantly between the self-injectable (54.1%) and the oral DMD cohorts (53.0%; P =0.5075). After controlling for covariates, index DMD type was not a significant predictor of adherence (odds ratio [OR] 1.062; 95% confidence interval [CI]: 0.937–1.202; P =0.3473). Higher likelihood of adherence was associated with male sex (OR 1.20; 95% CI: 1.085–1.335; P =0.0005) and age groups older than 18–34 years (ORs 1.220–1.331; P <0.01). Depression was associated with a lower likelihood of adherence (OR 0.618; 95% CI: 0.511–0.747; P <0.0001). Conclusion: Male sex and age older than 18–34 years were significantly associated with a higher likelihood of adherence, while depression was associated with a lower likelihood of adherence. Index DMD type, stratified by the route of administration (self-injectable vs oral DMD), was not a significant predictor of DMD adherence.
机译：目的：随着多发性硬化症（MS）疾病改变药物（DMD）的治疗选择已扩展到包括口服疗法，了解给药途径是否与DMD依从性相关很重要。这项研究的目的是比较新近开始使用自我注射与口服DMD进行治疗的MS患者对DMD的依从性。方法：这项回顾性数据库研究使用了2010年7月1日至2014年6月30日期间的IMS Health真实世界数据裁决的索赔-美国数据。依从性药物持有率（MPR）衡量依从性，计算方法为总治疗天数除以治疗所需天数。从第一个治疗日到12个月随访结束的总天数。使用二元测量值表示对治疗的依从性（MPR≥0.8）与不依从性（MPR <0.8）。 Logistic回归评估了遵守指数DMD类型（自注射与口服）的可能性。协变量包括患者基线特征（即年龄，性别，合并症）和DMD指数类型。结果：该分析包括7,207例自我注射和1,175例DMD口服治疗的MS患者。在未经调整的分析中，自我注射（54.1％）和口服DMD队列（53.0％; P = 0.5075）之间坚持治疗的患者比例（MPR≥0.8）没有显着差异。在控制协变量后，指数DMD类型不是依从性的重要预测指标（赔率[OR] 1.062; 95％置信区间[CI]：0.937–1.202; P = 0.3473）。依从性更高的可能性与男性（OR 1.20; 95％CI：1.085–1.335; P = 0.0005）和年龄在18-34岁以上的年龄组相关（ORs 1.220–1.331; P <0.01）。抑郁与依从性降低有关（OR 0.618; 95％CI：0.511–0.747; P <0.0001）。结论：年龄在18-34岁之间的男性和男性与依从的可能性显着相关，而抑郁与依从的可能性较低相关。通过给药途径（自注射与口服DMD）分层的DDM指数类型不是DMD依从性的重要预测指标。

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