Background and importance Patient beliefs about medication tools can measure patient concerns and the necessity for different long term treatment options, and can be related to adherence and quality of life (QoL).
Aim and objectives To determine beliefs about medication and QoL of patients with relapsing–remitting multiple sclerosis (RRMS) receiving active treatment with natalizumab and to analyse possible associations.
Material and methods This was a descriptive observational study including patients diagnosed with RRMS on active treatment with natalizumab. Variables collected from the clinical records were age, sex, time since diagnosis, expanded disability status scale (EDSS), adherence and duration of treatment. Patients completed the validated beliefs about medicines questionnaire which evaluates perceptions of personal necessity for medication and concerns about potential adverse effects (AE). Each questionnaire contains five questions, with the total sum scored of 5–25. The QoL was measured by the EuroQol-5D scale which has five dimensions (mobility, self-care, usual activities, pain/discomfort and anxiety/depression) with values of 0–1 and a visual analogue scale (VAS) with scores of 0–100 points. Patient consent was requested for participation. The possible associations were analysed by multivariate analysis with SPSS.
Results Fourteen patients (median age 40 years (IR 17–76), 78.6% women) were included. Median time from diagnosis was 8.5 years (IR 3–37). Median duration of treatment was 37 months (range 1–69). Adherence was 98% (IR 88–100%). Patients were classified into three groups according to EDSS: group A, 0–3 (57.2%); group B, 3.5–5.5 (21.4%); and group C, >6 (21.4%).
The average for concern was 11.3±4.5 and for necessity 16.8±4.0. The average QoL for EuroQol-5D was 0.59±0.28 and for VAS 63.2±9.5. In subgroup analysis, concern in groups A and B (12.7±4.3 and 13.3±4.7) was higher than in group C (6.5±0.7). Necessity followed the same distribution: groups A and B (17.3±3.1 and 17.3±4.9) were higher than group C (13.5±7.8). Multivariate analysis showed that patients with longer treatments were less concerned about AE (p<0.05). Significantly, patients with a higher EDSS had lower EuroQol-5D and VAS scores: group A (0.72±0.23 and 71.1±16.7), group B (0.37±0.2 and 46.7±5.8) and group C (0.36±0.34 and 52.5±31.8) (p<0.05). Older patients with longer time since diagnosis had lower QoL values (p<0.05).
Conclusion and relevance Most patients showed higher scores for perception of necessity for treatment than concern about the AE of natalizumab, which decreased with longer treatment. Patient disability, age and time significantly decreased QoL measures.
References and/or acknowledgements No conflict of interest.
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