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Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis : An Interview Study

Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis : An Interview Study

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PUST, Gesa E.A., Benthe UNTIEDT, Jennifer RANDERATH, Anna BARABASCH, Sascha KÖPKE, Anne C. RAHN, Hilke HANSEN, Christoph HEESEN, 2020. Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis : An Interview Study. In: International Journal of MS Care. Consortium of Multiple Sclerosis Centers. ISSN 1537-2073. Available under: doi: 10.7224/1537-2073.2018-068

@article{Pust2020-01-22Explo-48424, title={Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis : An Interview Study}, year={2020}, doi={10.7224/1537-2073.2018-068}, issn={1537-2073}, journal={International Journal of MS Care}, author={Pust, Gesa E.A. and Untiedt, Benthe and Randerath, Jennifer and Barabasch, Anna and Köpke, Sascha and Rahn, Anne C. and Hansen, Hilke and Heesen, Christoph} }

Heesen, Christoph Rahn, Anne C. 2020-01-22 Pust, Gesa E.A. Untiedt, Benthe Hansen, Hilke Randerath, Jennifer eng Barabasch, Anna Köpke, Sascha Köpke, Sascha Randerath, Jennifer Barabasch, Anna Background: Treatment adherence is fundamental in multiple sclerosis (MS) management. Adherence rates vary significantly between studies and range from only 30% to almost 90%, depending on assessment method and medication type. This study aimed to identify patient-related categories associated with a treatment modification or discontinuation in PwMS with first- and second-line treatment.<br /><br />Methods: Semi-structured interviews were performed in n = 11 PwMS with first-line treatment and n = 12 PwMS with second-line treatment. Medication history, experiences with prior medication, decision-making processes regarding immunotherapy, adherence behaviour and reasons for adherence/non-adherence were asked for in open 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. A Cohen's kappa of .76 for the PwMS with first-line treatment and .64 for the second-line sample was achieved between the two coders.<br /><br />Results: One key reason for non-adherence reported by PwMS with first-line treatment was “burdensome side effects,” and for adherence the “belief in medication effectiveness.” In PwMS with second-line treatment, a “lack of perceived medication effectiveness” was a a key category related to changes or a discontinuation of immunotherapy. Reasons for adherence were “positive illness beliefs/perceptions” and “the belief in a highly active disease.” Intentional non-adherence appeared as a major issue for first-line treatment and less relevant for second-line treatment,<br /><br />Conclusions: This study indicates specific differences in factors mitigating adherence between PwMS with first- and second-line treatment. Hansen, Hilke Exploring Adherence to First-Line and Second-Line Immunotherapies in Multiple Sclerosis : An Interview Study Rahn, Anne C. Pust, Gesa E.A. Heesen, Christoph Untiedt, Benthe 2020-01-30T09:50:25Z 2020-01-30T09:50:25Z

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