Background Mobility impairment is a major concern for patients with multiple sclerosis (MS). Dalfampridine improves walking speed. Nevertheless, it entails self-administration and there are few data on adherence rate, patient satisfaction and quality of life (QOL) in clinical practice.
Purpose To assess adherence, QOL and degree of patient satisfaction with dalfampridine in patients treated in our hospital.
Material and methods We included MS patients on dalfampridine treatment for at least 6 months from May 2014 to March 2015. Clinical data were collected from the patient’s chart: demographic information, duration and type of MS and Expanded Disability Status Scale (EDSS). On the pharmaceutical care office, adherence was measured by Morisky-Green questionnaire, patient satisfaction with a visual analogue scale (VAS) and patients QOL with improvement in the following items: mobility, self-care, daily activities, pain/discomfort and anxiety/depression.
Results 30 patients (46.7% female, mean age 39 years, mean duration of MS 13.7 years, mean EDSS 5.8) were included. Regarding the type of MS: 17 patients (57%) had relapsing-remitting MS, 9 (30%) secondary-progressive MS, 3 (10%) primary-progressive MS and 1 (3.3%) progressive-relapsing MS. 24 patients (80%) needed walking aids before treatment initiation. According to the Morisky-Green test, 21 (70%) patients were adherent to treatment. Regarding the motives for non-adherence, 7 (23.3%) patients had sometimes forgotten to take the drug, 1 (3.3%) patient did not administer the drug at the scheduled hours and did not respect the fasting period, and 2 (6.7%) patients decided not to take the drug because of side effects. Median general satisfaction VAS was 8 (IQR 7–9). Patients reported an improvement in the following QOL items: mobility (70%), anxiety/depression (33.3%), self-care (23.3%), daily activities (23.3%) and pain/discomfort (3.3%). 20% of patients reported that dalfampridine improved their fatigue.
Conclusion Other studies have reported a high level of adherence (97.5%) whereas in our experience it was suboptimal. It should be reinforced by hospital pharmacist in the follow-up. Patients reported high patient satisfaction and improvement in different scales for QOL.
References and/or Acknowledgements
Escolano Pueyo A, Navarro H, Perez C, et al. Our experience with fampridine in patients with multiple sclerosis after 2 years of treatment. Eur J Hosp Pharm 2015;22:A63-4
References and/or AcknowledgementsNo conflict of interest.
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