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4CPS-061 Application of proportion of day covered (PDC) to evaluate adherence and persistence to treatment with fingolimod in patients with multiple sclerosis
  1. C Botto1,
  2. A Palazzo2,
  3. M Santonocito1,
  4. G Cancellieri1,
  5. E De Luca1,
  6. S Realmuto3,
  7. D Lo Coco3,
  8. P Polidori2
  1. 1Università Degli Studi Di Palermo, Scuola Di Specializzazione In Farmacia Ospedaliera, Palermo, Italy
  2. 2Aoor Villa Sofia – Cervello, Uoc Farmacia, Palermo, Italy
  3. 3Aoor Villa Sofia – Cervello, Uoc Neurologia E Stroke Unit, Palermo, Italy


Background and Importance Multiple sclerosis (MS) is a chronic, neurodegenerative disease of the central nervous system with an unpredictable and potentially disabling course. Although there is no definitive cure for MS, the disease-modifying drugs (DMDs) represent available strategies to improve the patient’s quality of life treating relapses, modifying the disease course and managing symptoms. Therapeutic adherence is essential to obtain the efficacy of these treatments: poor adherence reduces its clinical effectiveness which can adversely impact disease progression, MS-related hospitalisation and mortality rates.

Aim and Objectives The aim of this study was to evaluate adherence and persistence to therapy with fingolimod, an oral DMD, in patients followed up by a MS reference centre.

Material and Methods With the aim to evaluate therapeutic adherence and persistence, a retrospective study has been conducted in collaboration with a neurology ward, by analysing the fingolimod prescriptions registered in a 12 months’ period (June 2021 – May 2022). This study has involved 46 patients. Data were obtained by consulting an informatic program indicating for each patient: age, therapy start and eventual end date, switch from or to other drugs. Adherence was calculated as proportion of days covered (PDC) and classified in low adherence (PDC<40%), partial adherence (PDC=40–79%) and adherence (PDC≥80%)1.

Results The study findings showed PDC values >80% in 41 patients (89.1%), 40%< PDC <80% in 1 patient (2.2%) and PDC<40% in 4 patients (8.7%). Among the patients with low adherence, two of these suspended definitively the treatment with fingolimod, two suspended it temporarily due to bad compliance, while one was lost at follow up. Anyway, 41 patients showed persistence to fingolimod treatment over 365 days.

Conclusion and Relevance From the data obtained it is possible to assert that the oral therapy with fingolimod presents good adherence and compliance, very important factors to get clinical effectiveness of MS pharmacological treatment. This study showed also the important role of hospital pharmacist, together with the clinician, in monitoring medication adherence.

References and/or Acknowledgements 1. Degli Esposti et al. Clinicoecon Outcomes Res. 2022; 14: 139–147.

Conflict of Interest No conflict of interest

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