Evidence map›Paper›PMID 31599395›Full record

ArticleClinical drug investigation2020

Assessing Barriers to Adherence with the Use of Dimethyl Fumarate in Multiple Sclerosis.

Angela Aungst, Lise Casady, Crystal Dixon, Janice Maldonado, Natalie Moreo, Laurie Pearsall, Derrick Robertson

Abstract read
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In one paragraph

Article in Clinical drug investigation, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Angela AungstDepartment of Neurology Morsani College of Medicine, University of South Florida, 13330 USF Laurel Dr, Tampa, FL, 33612, USA. aaungst@Health.usf.edu.ORCID http://orcid.org/0000-0002-8643-8788
Lise CasadyDepartment of Neurology Morsani College of Medicine, University of South Florida, 13330 USF Laurel Dr, Tampa, FL, 33612, USA.
Crystal DixonDepartment of Neurology, Miller School of Medicine, University of Miami, Miami, FL, USA.
Janice MaldonadoDepartment of Neurology Morsani College of Medicine, University of South Florida, 13330 USF Laurel Dr, Tampa, FL, 33612, USA.
Natalie MoreoDepartment of Neurology Morsani College of Medicine, University of South Florida, 13330 USF Laurel Dr, Tampa, FL, 33612, USA.
Laurie PearsallDepartment of Neurology Morsani College of Medicine, University of South Florida, 13330 USF Laurel Dr, Tampa, FL, 33612, USA.
Derrick RobertsonDepartment of Neurology Morsani College of Medicine, University of South Florida, 13330 USF Laurel Dr, Tampa, FL, 33612, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMultiple sclerosis (MS) is a chronic, inflammatory, central nervous system demyelinating disease that requires long-term use of disease-modifying therapies (DMT). Patient adherence to DMT is key in reducing the inflammation that leads to relapses and neurodegeneration. Dimethyl fumarate (DMF) poses unique challenges to adherence including being the only twice-daily dosing DMT. Previous research suggests there are direct roles that providers play on improving their patients' adherence rates, such as focusing on the patient-provider relationship, helping put the patient at ease so that they feel understood and respected. Also, route of administration affects adherence in other chronic healthcare conditions. However, the issue of adherence to DMT in MS is more complex than just route of administration, with adverse effects being the main predictor of adherence.

objectives(1) To define various patient specific factors (e.g. fatigue and mood disorders) that affect adherence with DMF and (2) to understand how patients' perceptions of treatment satisfaction (such as effectiveness, convenience, side effects and global satisfaction) and DMFs impact on quality of life (such as social support, activities of daily living, coping) influence adherence.

methodsOur study was a prospective, observational measurement of adherence to treatment with DMF in MS patients over 52 weeks. Twenty-five out of thirty-five patients enrolled completed the study. Adverse event (AE) data was reviewed on all participants.

resultsAdherence rates correlated with patient's perceived effectiveness (0.25, p < 0.023) and the level of bothersome symptoms the patient experienced (0.45, p < 0.0001). The majority of new AE onset was reported within 12 weeks of DMF initiation. This is consistent with previously published data with DMF use.

conclusionAdherence rates are an important factor to be considered when starting patients on DMT. DMF creates its own barriers to adherence with our study highlighting some, including twice-daily dosing and AEs experienced following treatment initiation. Healthcare providers should be aware of these barriers prior to treatment initiation and counsel patients appropriately.

Indexed as

Activities of Daily LivingAdultDimethyl FumarateFemaleHumansImmunosuppressive AgentsMaleMedication AdherenceMiddle AgedMultiple SclerosisProspective StudiesQuality of LifeDimethyl FumarateImmunosuppressive Agents

Identifiers

PMID31599395

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.