Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis: An Interview Study
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Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis: An Interview Study. / Pust, Gesa E A; Untiedt, Benthe; Randerath, Jennifer; Barabasch, Anna; Köpke, Sascha; Rahn, Anne C; Hansen, Hilke; Heesen, Christoph.
in: Int J MS Care, Jahrgang 22, Nr. 5, 13.11.2020, S. 219-225.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis: An Interview Study
AU - Pust, Gesa E A
AU - Untiedt, Benthe
AU - Randerath, Jennifer
AU - Barabasch, Anna
AU - Köpke, Sascha
AU - Rahn, Anne C
AU - Hansen, Hilke
AU - Heesen, Christoph
N1 - © 2020 Consortium of Multiple Sclerosis Centers.
PY - 2020/11/13
Y1 - 2020/11/13
N2 - Background: Treatment adherence is fundamental in multiple sclerosis (MS) management. Adherence rates vary significantly between studies, ranging from 30% to almost 90%, depending on assessment method and medication type. This study aimed to identify patient-related categories associated with treatment modification or discontinuation in people with MS receiving either first- or second-line treatment.Methods: Semistructured interviews were performed with 23 people with MS: 11 receiving first-line treatment and 12 receiving second-line treatment. Medication history, experiences with previous medications, decision-making processes regarding immunotherapy, adherence behavior, and reasons for adherence/nonadherence were explored using open-ended questions. Qualitative content analysis was performed using a combined deductive-inductive approach in building a coding frame. Differences in coding frequencies were compared between the two groups and analyzed quantitatively. Cohen's kappas of 0.76 for people with MS receiving first-line treatment and 0.64 for the second-line sample were achieved between the two coders.Results: One key reason for nonadherence reported by first-line-treated people with MS was burdensome side effects, and for adherence was belief in medication effectiveness. In people with MS receiving second-line treatment, lack of perceived medication effectiveness was a key category related to changes in or discontinuation of immunotherapy. Reasons for adherence were positive illness beliefs/perceptions and belief in highly active disease. Intentional nonadherence was a major issue for first-line treatment and less relevant for second-line treatment.Conclusions: These results indicate specific differences in factors mitigating adherence in people with MS receiving first- and second-line treatment.
AB - Background: Treatment adherence is fundamental in multiple sclerosis (MS) management. Adherence rates vary significantly between studies, ranging from 30% to almost 90%, depending on assessment method and medication type. This study aimed to identify patient-related categories associated with treatment modification or discontinuation in people with MS receiving either first- or second-line treatment.Methods: Semistructured interviews were performed with 23 people with MS: 11 receiving first-line treatment and 12 receiving second-line treatment. Medication history, experiences with previous medications, decision-making processes regarding immunotherapy, adherence behavior, and reasons for adherence/nonadherence were explored using open-ended questions. Qualitative content analysis was performed using a combined deductive-inductive approach in building a coding frame. Differences in coding frequencies were compared between the two groups and analyzed quantitatively. Cohen's kappas of 0.76 for people with MS receiving first-line treatment and 0.64 for the second-line sample were achieved between the two coders.Results: One key reason for nonadherence reported by first-line-treated people with MS was burdensome side effects, and for adherence was belief in medication effectiveness. In people with MS receiving second-line treatment, lack of perceived medication effectiveness was a key category related to changes in or discontinuation of immunotherapy. Reasons for adherence were positive illness beliefs/perceptions and belief in highly active disease. Intentional nonadherence was a major issue for first-line treatment and less relevant for second-line treatment.Conclusions: These results indicate specific differences in factors mitigating adherence in people with MS receiving first- and second-line treatment.
U2 - 10.7224/1537-2073.2018-068
DO - 10.7224/1537-2073.2018-068
M3 - SCORING: Journal article
C2 - 33177958
VL - 22
SP - 219
EP - 225
JO - Int J MS Care
JF - Int J MS Care
SN - 1537-2073
IS - 5
ER -