Beliefs about Medicines and the Level of Intentional Non-Adherence to Treatment among Patients with Multiple Sclerosis Treated with First-Line Drugs
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Design
- (1)
- Fulfilled the McDonald’s criteria;
- (2)
- Treatment with DMT therapy;
- (3)
- Signed informed consent.
2.2. Questionnaires
- The Intentional Non-Adherence Scale (INAS) is a scale to assess intentional non-adherence to prescribed medications [9]. The questionnaire consists of 22-item scale scored on a 5-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, 5 = strongly agree). The final score ranges between 22 and 110, and higher scores indicate poorer adherence.
2.3. Ethical Consideration
2.4. Statistical Methods
3. Results
3.1. Sociodemographic and Clinical Characteristics
3.2. Level of Intentional Non-Adherence (INAS Scores) and Beliefs about Medication (BMQ Scores)
3.3. Correlation between Non-Adherence and Beliefs about Medication
4. Discussion
5. Study Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | (n = 148) | |
---|---|---|
Age [years] | mean ± SD | 43.9 ± 10.19 |
median | 42 | |
quartiles | 37–50 | |
EDSS [score] | mean ± SD | 2.38 ± 1.27 |
median | 2 | |
quartiles | 1.5–3 | |
Duration of the disease [years] | mean ± SD | 12.07 ± 6.35 |
median | 11.5 | |
quartiles | 7–17 | |
Number of relapses in the last two years? | mean ± SD | 0.62 ± 1.08 |
median | 0 | |
quartiles | 0–1 | |
Duration of DMTs use (years) | mean ± SD | 6.22 ± 3.67 |
median | 6 | |
quartiles | 0.3–9 | |
Gender, n (%) | Female | 100 (67.57%) |
Male | 48 (32.43%) | |
Form of the medicine, n (%) | Injections | 61 (41.22%) |
Tablets | 87 (58.78%) | |
Place of residence, n (%) | Village | 35 (23.65%) |
City < 50 thousand residents | 40 (27.03%) | |
City 50–500 thousand residents | 20 (13.51%) | |
City > 500 thousand residents | 53 (35.81%) | |
Education, n (%) | Basic or vocational education | 23 (15.54%) |
Secondary education | 55 (37.16%) | |
Higher education | 70 (47.30%) | |
Marital status, n (%) | Single | 30 (20.27%) |
Married | 101 (68.24%) | |
Divorced | 16 (10.81%) | |
Widowed | 1 (0.68%) | |
Occupational activity, n (%) | Active/working | 101 (68.24%) |
Retired | 12 (8.11%) | |
Pension | 23 (15.54%) | |
Unemployed | 10 (6.76%) | |
Student | 2 (1.35%) | |
Complains, n (%) | Speech disorders | 19 (12.84%) |
Hypertonia | 33 (22.30%) | |
Mood disorders | 44 (29.73%) | |
Sensory disorders | 32 (21.62%) | |
Mobility and balance disorders | 84 (56.76%) | |
Sexual disorders | 39 (26.35%) | |
Vision disorders | 73 (49.32%) | |
Sphincter disorders | 52 (35.14%) | |
Dysphagia | 12 (8.11%) | |
Fatigability | 105 (0.95%) |
Mean | SD | Median | Min | Max | Q1 | Q3 | ||
---|---|---|---|---|---|---|---|---|
INAS | 51.41 | 27.83 | 47.0 | 22 | 110 | 22.00 | 66 | |
BMQ | Overuse | 11.28 | 2.50 | 11.5 | 5 | 20 | 9.25 | 13 |
BMQ | Harm | 10.69 | 2.55 | 11.0 | 4 | 20 | 9.00 | 12 |
BMQ | Necessity | 18.30 | 3.41 | 18.0 | 7 | 25 | 16.00 | 21 |
BMQ | Concerns | 14.17 | 3.29 | 14.0 | 5 | 21 | 12.00 | 16 |
Variable | Parametr | 95% CI | p | ||
---|---|---|---|---|---|
Gender | Female | ref. | |||
Male | 7.406 | −2.129 | 16.941 | 0.13 | |
Age [years] | 0.348 | −0.091 | 0.788 | 0.123 | |
Form of the medicine | Injections | ref. | |||
Tablets | 7.648 | −1.408 | 16.703 | 0.1 | |
EDSS score | 0.142 | −3.406 | 3.69 | 0.938 | |
Place of residence | Village | ref. | |||
City < 50 thousand residents | 6.718 | −5.94 | 19.375 | 0.3 | |
City 50–500 thousand residents | −1.207 | −16.536 | 14.122 | 0.878 | |
City > 500 thousand residents | −1.387 | −13.299 | 10.524 | 0.82 | |
Education | Basic or vocational education | ref. | |||
Secondary education | −0.236 | −13.741 | 13.27 | 0.973 | |
Higher education | −7.859 | −20.931 | 5.213 | 0.241 | |
Marital status | Single | ref. | |||
Married | −2.477 | −13.778 | 8.824 | 0.668 | |
Divorced, Widowed | 10.184 | −6.315 | 26.684 | 0.228 | |
Occupational activity | Active/working, student | ref. | |||
Retired | 16.141 | −0.374 | 32.657 | 0.057 | |
Pension | 9.388 | −3.099 | 21.875 | 0.143 | |
Unemployed | 1.775 | −16.159 | 19.709 | 0.846 | |
Disease duration (years) | 0.098 | −0.612 | 0.808 | 0.787 | |
Number of relapses in the last two years? | 1.101 | −3.083 | 5.285 | 0.607 | |
Duration of DMTs use (years) | 0.339 | −0.978 | 1.657 | 0.614 | |
Speech disorders | No | ref. | |||
Yes | 4.055 | −9.378 | 17.488 | 0.555 | |
Hypertonia | No | ref. | |||
Yes | 0.215 | −10.593 | 11.024 | 0.969 | |
Mood disorders | No | ref. | |||
Yes | −4.82 | −14.631 | 4.992 | 0.337 | |
Sensory disorders | No | ref. | |||
Yes | −6.342 | −17.222 | 4.538 | 0.255 | |
Mobility and balance disorders | No | ref. | |||
Yes | −1.446 | −10.524 | 7.632 | 0.755 | |
Sexual disorders | No | ref. | |||
Yes | −3.515 | −13.711 | 6.681 | 0.5 | |
Vision disorders | No | ref. | |||
Yes | −8.277 | −17.175 | 0.621 | 0.07 | |
Sphincter disorders | No | ref. | |||
Yes | −1.551 | −10.972 | 7.869 | 0.747 | |
Dysphagia | No | ref. | |||
Yes | 2.634 | −13.842 | 19.11 | 0.754 | |
Fatigability | No | ref. | |||
Yes | −3.907 | −13.796 | 5.981 | 0.44 |
Variable | Parametr | 95%CI | p | ||
---|---|---|---|---|---|
Gender | Female | ref. | |||
Male | 8.599 | −0.68 | 17.877 | 0.072 | |
Age | [years] | 0.137 | −0.347 | 0.622 | 0.58 |
Form of the medicine | Injections | ref. | |||
Tablets | 7.896 | −1.041 | 16.834 | 0.086 | |
Occupational activity | Active/working, student | ref. | |||
Retired | 11.632 | −6.272 | 29.537 | 0.205 | |
Pension | 7.226 | −5.24 | 19.693 | 0.258 | |
Unemployed | 5.642 | −11.469 | 22.753 | 0.519 | |
Vision disorders | No | ref. | |||
Yes | −6.497 | −15.22 | 2.226 | 0.147 | |
BMQ: Overuse | 4.204 | 0.997 | 7.411 | 0.011 * | |
BMQ: Harm | −0.001 | −3.223 | 3.222 | 1 | |
BMQ: Necessity | 0.244 | −1.05 | 1.538 | 0.712 | |
BMQ: Concerns | −1.365 | −2.866 | 0.136 | 0.077 |
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Kołtuniuk, A.; Chojdak-Łukasiewicz, J. Beliefs about Medicines and the Level of Intentional Non-Adherence to Treatment among Patients with Multiple Sclerosis Treated with First-Line Drugs. J. Clin. Med. 2024, 13, 182. https://doi.org/10.3390/jcm13010182
Kołtuniuk A, Chojdak-Łukasiewicz J. Beliefs about Medicines and the Level of Intentional Non-Adherence to Treatment among Patients with Multiple Sclerosis Treated with First-Line Drugs. Journal of Clinical Medicine. 2024; 13(1):182. https://doi.org/10.3390/jcm13010182
Chicago/Turabian StyleKołtuniuk, Aleksandra, and Justyna Chojdak-Łukasiewicz. 2024. "Beliefs about Medicines and the Level of Intentional Non-Adherence to Treatment among Patients with Multiple Sclerosis Treated with First-Line Drugs" Journal of Clinical Medicine 13, no. 1: 182. https://doi.org/10.3390/jcm13010182