Treatment discontinuation in multiple sclerosis: The French Web-based survey ALLIANCE. (18th August 2015)

• Record Type: Journal Article
• Authors: Donzé, Cécile; Malapel, Lucie; Kwiatkowski, Arnaud; Lenne, Bruno; Louchard, Pierre; Neuville, Véronique; Hautecoeur, Patrick
• Is Part Of: Multiple sclerosis journal, experimental, translational and clinical. Volume 1(2015)
• Publication Date: 2015-08-18
• Subjects: Multiple sclerosis -- disease-modifying therapies -- treatment discontinuation -- Web survey -- patient adherence; Multiple sclerosis -- Periodicals; 616.834
• DOI: 10.1177/2055217315600720
• Languages: English
• ISSNs: 2055-2173

Abstract

Background: In multiple sclerosis (MS), treatment discontinuation leads to a higher risk of relapse, poorer quality of life and greater economic impact. Objective: The objective of this work is to evaluate treatment discontinuation in MS, the reasons for this and the reasons for treatment resumption. Methods: A French national Web-based survey was carried out between May and August 2011. A total of 602 MS patients answered a questionnaire on sociodemographic data, medical follow-up, disease-modifying therapies (DMTs), symptomatic treatments, care given, factors involved in treatment discontinuation and reasons for resuming treatment. Results: Among 413 patients using DMTs, 54% have considered discontinuing their treatment, primarily because of anger (61%), side effects (61%) and fatigue (57%). Sixty-eight patients have actually discontinued their treatment because of side effects (43%), lack of observed outcomes (32%), exasperation (29%) or fatigue (29%). The reasons for symptomatic treatment discontinuation were fear of addiction (32%–46%) and lack of efficacy (28%–45%). Physiotherapy was discontinued because of fatigue (37%), stress (34%) or inefficiency (31%). According to patients, treatment discontinuation could have been prevented by psychological support, care team empathy and support from family. Conclusion: The major factor that could prevent treatment discontinuation is psychological support. Initiating and monitoring treatment in MS leads to emotional and personality changes, requiring adaptations that may improve compliance.