Abstract
BackgroundAdherence to disease-modifying treatment (DMT) amongst people with multiple sclerosis (MS) varies greatly. Although research often identifies 'forgetting' as a reason for poor adherence, few studies have considered how cognitive problems impact adherence. ObjectivesTo investigate prevalence of and barriers to adherence, including for people with MS-related cognitive problems, and to identify adherence-related strategies. MethodsRecruited via the UK MS Register and MS Society groups, participants completed a Medication Adherence Questionnaire and the Perceived Deficits Questionnaire. A subset were interviewed. Results: Of 257 participants, 94 % reported being adherent, although 59 % missed ≥1 dose, and 25 % reported cognitive problems. Adherence was lower amongst those with cognitive problems, who experienced more barriers: memory problems; negative feelings about taking medication; and not wanting medication to interfere with activities. Such barriers, along with mood, cognition, and method of DMT administration, explained 17 % of variance in adherence, with intravenous treatment a significant predictor. Cognitive problems explained a unique proportion of variance; however, was non-significant when anxiety was factored in. Interviews highlighted how anxiety about side-effects and injections, and difficulties accepting the diagnosis, hindered use of reminders. ConclusionInterventions for cognition and mood problems, minimising treatment burden and supporting adjustment to diagnosis, may improve adherence.
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