https://www-sciencedirect-com.proxy.lib ... 4820300924
• A third of Canadian MS patients chose not to take MS treatments despite active disease.
• Patients preferred naturopathic medications or conservative approaches for management.
• Delay in MS diagnosis was associated with a lower likelihood for starting medication.
• Adverse events from medication were most common reason for stopping MS treatments.
Factors associated with adherence to disease modifying therapies (DMT) in patients with Multiple Sclerosis (MS) have been reported before, but little has been studied on compliance to a physician's initial treatment recommendations. The objective of this study was to assess the factors associated with compliance to physician recommended treatment in treatment-naïve patients with MS.
We studied a cohort of patients with MS followed at an academic MS center in Toronto, Canada between January 2015 and May 2018. We used log-binomial models to identify patient-level factors (age, sex, and smoking history), and MS-specific clinical details (delay in diagnosis, and age at diagnosis) associated with compliance.
Of the 332 patients, 256 (77.1%) were recommended DMT and 80 (31.3%) did not follow the recommendation. The most common causes for refusal to initiate DMT were: personal preference to not embark on a medication (46.2%), wishing to use a conservative approach (22.5%) or use of complementary medical approaches (18.8%). Twenty-one () patients who initially were compliant to treatment recommendations subsequently stopped DMT against medical advice. The two most common reasons for this nonadherence included adverse effects (61.8%) and personal preference (19.0%). Every year delay in the diagnosis of MS was associated with a lower risk of compliance (risk ratio 0.97, 95% CI, 0.94–1.00).
Non-compliance to DMT recommendation in patients with MS in a Canadian practice is sizable, due to patients’ own perspectives of disease and their belief in alternative complementary medicine."
'belief' lol yeah it's too bad some of these alternatives aren't sufficiently lucrative to merit more well-designed research for the evidence base.
take control of your own health.
pursue optimal self care, with or without a diagnosis.
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