RT Journal Article
SR Electronic
T1 Treatment adherence and unmet needs at hospital pharmacy for the care of Spanish patients with multiple sclerosis
JF European Journal of Hospital Pharmacy: Science and Practice
JO Eur J Hosp Pharm
FD British Medical Journal Publishing Group
SP 20
OP 25
DO 10.1136/ejhpharm-2012-000183
VO 20
IS 1
A1 Emilio Monte-Boquet
A1 Laura Lorente-Fernández
A1 Ignacio Cardona-Pascual
A1 Miguel Ángel Conesa-Muñoz
A1 María Fernández-Pacheco
A1 Javier García-Fernández
A1 Ana García-Monsalve
A1 María Olatz Ibarra-Barrueta
A1 Aitziber Illaro-Uranga
A1 Luís Margusino-Framiñán
A1 Jesús Mayorga-Pérez
A1 Isabel Moya-Carmona
A1 Paula Pérez-Puente
A1 María Ángeles Porta-Sánchez
A1 Inmaculada Ramírez-Alapont
A1 Patricia Sanmartín-Fenollera
A1 Elena Victoria Tortajada-Esteban
A1 José Ramón Vizoso-Hermida
A1 Sheila Mora-García
A1 on behalf of the EMHOPHAR Study Group
YR 2013
UL http://ejhp.bmj.com/content/20/1/20.abstract
AB 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.