INTRODUCCIÓN 9

ABSTRACT

Multiple Sclerosis (MS) is a prevalent disease in our country, where National Health coverage provides access to disease-modifying treatments (DMTs), despite their high cost. Poor adherence to these therapies may decrease their effectiveness and challenge the control of the MS evolution. The purpose of this study is to analyze the factors related to poor adherence in the patients treated in the Universitary Hospital of Fuenlabrada and identify those patients in risk of treatment failure due to lack of compliance. DMT prescriptions were retrospectively analysed from January 2004 to January 2022, identifying those patients with less than 80% adherence to the treatment. Medical records were reviewed to obtain the clinical and demographical factors that may influence compliance. Bivariant and multivariant statistical analysis of the variables obtained was performed. 549 DMTs were dispensed at our hospital in the period of the study with and adherence rate of 87%. Abusive consumption of alcohol and toxic substances and presence (OR 22.83; IC 95% 7.32-71.20), and presence of cognitive impairment ((OR 3.82; IC 95%1.51- 9.70) significantly increased the risk of poor compliance in our series. Other risk factors identified were psychiatric comorbidity (OR 1.56; 0.75-3.24 p. 0.233), polypharmacy (OR 1.65; IC 95% 0.65-4.18 p 0.287) and higher levels of disability (OR 1.63; IC 95% 1.07-2.49 p 0.023). Relapsing-remitting form of MS (OR 0.32; IC 95% 0.90-1.14 p 0.078) and oral administration (OR 0.29; IC 95% 0.12-0.75 p 0.010) resulted protective in our series. This study allowed us to identify the main factors related to poor compliance in our population. The identification of these factors in clinical practice will help us recognise those patients prone to lack of adherence and may be useful in implementing new follow-up strategies to prevent it.

Estudio de la adherencia al tratamiento modificador de la enfermedad en pacientes de Esclerosis Múltiple atendidos en el Hospital de Fuenlabrada Rodrigo Fernández de Córdoba García