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Titre : | Risk Factors for Suboptimal Medication Adherence in Persons With Multiple Sclerosis: Development of an Electronic Health Record-Based Explanatory Model for Disease-Modifying Therapy Use (2020) |
Auteurs : | Elizabeth S. Gromisch ; Aaron P. Turner ; Steven L. Leipertz |
Type de document : | Article |
Dans : | Archives of Physical Medicine and Rehabilitation (Vol. 101, n° 5, 2020) |
Article en page(s) : | p. 807-814 |
Note générale : | https://doi.org/10.1016/j.apmr.2019.11.005 |
Langues: | Anglais |
Descripteurs : |
HE Vinci Adhésion au traitement médicamenteux ; Dossiers médicaux électroniques ; Facteurs de risque ; Réadaptation ; Rendez-vous et plannings ; Sclérose en plaques |
Résumé : |
Objective
To determine which factors are associated with suboptimal disease-modifying therapy (DMT) adherence and to develop an explanatory model that could be used to identify individuals at risk and potentially inform interventions. Design Cross-sectional cohort study using electronic health records. Setting Veterans Health Administration (VA). Participants Veterans with multiple sclerosis (MS) (N=2939; 79.69% men) who received care through the VA and were included in the VA MS Center of Excellence Data Repository. Interventions Not applicable. Main Outcome Measures Suboptimal DMT adherence ( Results Nearly 31% of participants had suboptimal adherence. Flags for suboptimal adherence included >20% missed appointments (odds ratio [OR], 3.78; 95% CI, 2.45-2.82), traumatic brain injuries (OR, 1.55; 95% CI, 1.12-2.14), age younger than 59 years (OR, 1.47; 95% CI, 1.23-1.74), ≥1 emergency department visits (OR, 1.40; 95% CI, 1.18-1.67), mood disorders (ie, depressive and bipolar disorders) (OR, 1.40; 95% CI, 1.18-1.66), and service connection (OR, 1.22; 95% CI, 1.01-1.47). Hyperlipidemia (OR, 0.77; 95% CI, 0.65-0.92) and being issued a wheelchair (OR, 0.83; 95% CI, 0.70-1.00) were associated with lower risk. Conclusions Suboptimal adherence to DMTs continues to be an issue. Interventions that focus on person-level barriers should be urgently explored to increase adherence and improve self-management abilities. |
Disponible en ligne : | Oui |
En ligne : | https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/article/pii/S0003999319314303 |