Objective To assess unmet needs at hospital pharmacies and treatment adherence of patients with multiple sclerosis (MS) treated with disease-modifying therapies (DMTs).
Methods A non-interventional and multicentre study involving 24 pharmacies that included 237 patients with relapsing-remitting MS (RRMS) or secondary progressive MS (SPMS) treated with DMTs. Pharmacists completed a questionnaire on management and needs. Adherence was assessed using the Morisky-Green test.
Results The mean age of patients was 40.1±9.4 years (65.8% women). The average time from diagnosis was 7.5±5.6 years, 95.4% had RRMS and 61.2% had no relapses during the last year. Most patients (62.4%) had Expanded Disability Status Scale grade 0–2.5. Overall adherence was 77.1%. Treatment adherence was significantly higher among patients with no relapses (82.9% vs 67.4%, p<0.05) and among those ≥40 years old (85.1% vs 68.3%, p<0.05). 21.1% of pharmacies did not have adequate educational materials and in 16% of cases there was no proper space to assure confidentiality. A specific protocol to monitor adverse events only existed in 21% of pharmacies and to monitor adherence in 32%. Major unmet needs for pharmacists were educational materials, adherence training, staff shortages and increased workload. There was a trend towards lower adherence at hospitals with a higher workload (68.6% vs 80.2%) and with a lack of educational materials (75.2% vs 84.6%). In 19.8% of cases there was a discrepancy between pharmacist perception of adherence and the Morisky-Green test.
Conclusions It is necessary to improve educational materials and operational protocols regarding workload at hospital pharmacies to provide adequate follow-up and to ensure adherence by Spanish patients with MS.
- Multiple Sclerosis
- hospital pharmacists
- treatment adherence
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