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首页> 外文期刊>Journal of neurology >A multicenter study of the predictors of adherence to self-injected glatiramer acetate for treatment of relapsing-remitting multiple sclerosis.
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A multicenter study of the predictors of adherence to self-injected glatiramer acetate for treatment of relapsing-remitting multiple sclerosis.

机译：一项多中心研究，研究了坚持使用自我注射醋酸格拉替雷治疗复发缓解型多发性硬化症的预测指标。

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Treatment with disease-modifying immunomodulators is recommended for patients with relapsing-remitting MS (RRMS). However, continuous adherence to treatment with these injected therapies can be challenging. The main objective was to examine the predictors of adherence to glatiramer acetate using a study model derived from Prochaska's transtheoretical model of change. We conducted a 12-week, prospective, observational study. Potential predictors included readiness stage, MS self-efficacy, decisional balance (pros and cons of self-injection), and injection competence. Adults with RRMS, either treatment-naive (TN) or treatment-experienced (TE), taking glatiramer acetate for the first time were studied. Interventions (including injection training) were implemented to promote adherence. The evaluable population included 146 TN patients and 88 TE patients who had previously discontinued beta-interferons. Adherence rates did not differ between TN and TE groups (86% for both at week 12); however, predictors of adherence did. For TN patients, greater functional self-efficacy, higher self-injection competence at baseline, and improvement in self-injection competence over the first month of therapy predicted adherence. For TE patients, lower body mass index and longer duration of MS predicted adherence. Interventions to improve self-efficacy and self-injection competence should be a priority when treating TN patients. Behavioral predictors of adherence in TE patients warrant further study.
机译：对于复发缓解型MS（RRMS）的患者，建议使用改变疾病的免疫调节剂进行治疗。然而，持续坚持用这些注射疗法进行治疗可能是具有挑战性的。主要目的是使用从Prochaska的跨理论变化模型得出的研究模型，检查对醋酸格拉替雷依从性的预测指标。我们进行了为期12周的前瞻性观察研究。潜在的预测因素包括准备阶段，MS自我效能，决策平衡（自我注射的利弊）和注射能力。研究了初次服用醋酸格拉替雷的未治疗（TN）或未经治疗（TE）的RRMS成人。实施干预措施（包括注射培训）以促进依从性。可评估的人群包括146位TN患者和88位TE患者，这些患者以前曾停用过β-干扰素。 TN组和TE组之间的依从率没有差异（第12周，两组的依从率均为86％）;但是，依从性的预测因子确实如此。对于TN患者，在治疗的第一个月内，更高的功能自我效能，更高的基线自我注射能力以及自我注射能力的改善预示了依从性。对于TE患者，较低的体重指数和较长的MS持续时间可预测依从性。治疗TN患者时，应优先采取提高自我效能和自我注射能力的干预措施。 TE患者依从性的行为预测指标值得进一步研究。

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