Adherence with Treatment Recommendations

Adherence with disease-modifying therapies has been found to be a problem for many persons with MS. Currently, it is estimated that only 70,000 of approximately 350,000 people with MS are receiving treatment with recommended disease-modifying agents. A recent study found that one-third of people stop treatment within the first nine months. The major reason given was the patient’s perception that the drugs weren’t working; MS symptoms either stayed the same or actually progressed.

It is known that disease-modifying agents are known to be only partially effective – i.e., they may slow disease progression, but don’t halt disease progression or cure the disease. It is important for healthcare professionals to support the patient’s optimism and hope for a benign disease course while continuing to emphasize the potential benefit of early treatment for a chronic and unpredictable disease.

Patients who are receiving treatment for MS associated depression – either with antidepressants or with psychotherapy – are significantly more likely to continue to take disease-modifying drugs. Health care professionals can help increase patient compliance by promoting realistic expectations about the results of treatment, taking time to listen to patient concerns, clarifying misconceptions about therapy, and helping patients manage drug side effects.

Approximately a third of patients with MS may be using complementary and alternative medicine therapies, such as St. John’s Wort for depression. Because of potential drug interactions with complementary and alternative therapies, patients should be encouraged to speak to their physicians before starting additional prescribed or over-the-counter medications or substances purchased at health food stores.

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A large number of people stop taking disease-modifying drugs because their symptoms don’t improve or even increase.