Risk Factors for Suboptimal Medication Adherence in Persons with Multiple Sclerosis: Development of an Electronic Health Record-Based Explanatory Model for Disease-Modifying Therapy Use.Gromisch ES, Turner AP, Leipertz SL, Beauvais J, Haselkorn JK. Arch Phys Med Rehabil. 2019 Dec 3. pii: S0003-9993(19)31430-3.
OBJECTIVE:To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence, and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions.
DESIGN:Cross-sectional cohort study using electronic health records.
PARTICIPANTS:Veterans with multiple sclerosis (MS; N = 2,939; 79.69% men) who received care through the VA and were included in the VA MS Center of Excellence Data Repository.
MAIN OUTCOME MEASURES: Suboptimal DMT adherence (<80%), demographics, co-occurring conditions, and healthcare utilization.
RESULTS:Nearly 31% of participants had suboptimal adherence. Flags for suboptimal adherence included >20% missed appointments (odds ratio [OR]: 3.78, 95% CI: 2.45, 2.82), age less than 59 (OR: 1.47, 95% CI: 1.23, 1.74), one or more emergency room visits (OR: 1.40, 95% CI: 1.18, 1.67), mood disorders (i.e., depressive and bipolar disorders; OR: 1.40, 95% CI: 1.18, 1,66), and service connection (OR: 1.22, 95% CI: 1.01, 1.47).
Hyperlipidemia (OR: 0.77, 95% CI: 0.65, 0.92) and being issued a wheelchair (OR: 0.83, 95% CI: 0.70, 1.00) were associated with lower risk.
CONCLUSIONS: Suboptimal adherence to DMTs continues to be an issue. Interventions that focus on person-level barriers should be urgently explored to increase adherence and improve self-management abilities.
I have some pills to take and I know how difficult it is to remember to take them. This study looks at Ex-soldiers from the US and sees a number of issues. What tips do you have, to remember to take your medication?