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| Title |
Adherence to fingolimod in multiple sclerosis: an investigator-initiated, prospective, observational, single-center cohort study
|
|---|---|
| Published in |
Patient preference and adherence, October 2017
|
| DOI | 10.2147/ppa.s140293 |
| Pubmed ID | |
| Authors |
Andrea Zimmer, Michael Coslovsky, Ivo Abraham, Bernhard F Décard |
| Abstract |
Adherence to multiple sclerosis (MS) treatment is essential to optimize the likelihood of full treatment effect. This prospective, observational, single-center cohort study investigated adherence to fingolimod over the 2 years following treatment initiation. Two facets of adherence - implementation and persistence - were examined and compared between new and experienced users of disease-modifying treatments (DMTs). Implementation rates were based on the proportion of days covered and calculated as percentages per half-yearly visits and over 2 years, captured through refill data, pill count, and self-report. Nonadherence was defined as taking less than 85.8% of prescribed pills. Implementation rates were classified as nonadherent (<85.8%), suboptimally adherent (≥85.8% but <96.2%), and optimally adherent (≥96.2%), including perfectly adherent (100%). Persistence, ie, time until discontinuation, was analyzed by Kaplan-Meier analysis. Reasons for discontinuation were recorded. The cohort included 98 patients with relapsing MS, all of whom received a dedicated education session about their medication. Of these 80% were women, 31.6% had fingolimod as first DMT, and 68.4% had switched from other DMTs. The mean implementation rate over 2 years was 98.6% (IQR1-3 98.51%-98.7%) and did not change significantly over time; 89% of measurements were in the optimally adherent category, 45.6% in the perfectly adherent category. There was one single occurrence of nonadherence. New users of DMTs were 1.29 times more likely to be adherent than experienced users (OR 1.29, 95% CI 1.11-1.51; P<0.001), but not more persistent. Nineteen of 98 patients discontinued fingolimod. The very high implementation rates displayed in this sample of MS patients suggest that facilitation by health care professionals in preserving adherence behavior may be sufficient for the majority of patients. Targeted interventions should focus on patients who are nonadherent or who stop treatment without intention to reinitiate. |
X Demographics
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 40 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 40 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 5 | 13% |
| Student > Bachelor | 4 | 10% |
| Student > Ph. D. Student | 4 | 10% |
| Student > Doctoral Student | 3 | 8% |
| Lecturer | 2 | 5% |
| Other | 8 | 20% |
| Unknown | 14 | 35% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 10 | 25% |
| Psychology | 4 | 10% |
| Business, Management and Accounting | 3 | 8% |
| Nursing and Health Professions | 3 | 8% |
| Pharmacology, Toxicology and Pharmaceutical Science | 2 | 5% |
| Other | 4 | 10% |
| Unknown | 14 | 35% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 23 October 2017.
All research outputs
#18,574,814
of 23,006,268 outputs
Outputs from Patient preference and adherence
#1,317
of 1,617 outputs
Outputs of similar age
#247,035
of 322,475 outputs
Outputs of similar age from Patient preference and adherence
#29
of 35 outputs
Altmetric has tracked 23,006,268 research outputs across all sources so far. This one is in the 11th percentile – i.e., 11% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,617 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one is in the 6th percentile – i.e., 6% of its peers scored the same or lower than it.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 322,475 tracked outputs that were published within six weeks on either side of this one in any source. This one is in the 12th percentile – i.e., 12% of its contemporaries scored the same or lower than it.
We're also able to compare this research output to 35 others from the same source and published within six weeks on either side of this one. This one is in the 5th percentile – i.e., 5% of its contemporaries scored the same or lower than it.