Medication Adherence in Multiple Sclerosis Treatment

Effective management of multiple sclerosis (MS) relies heavily on sustained use of disease-modifying therapies (DMTs) to reduce relapse frequency, slow disability progression and preserve quality of life. Despite clear clinical benefits, adherence rates in real-world settings remain suboptimal, with one in five patients failing to take medications as prescribed and one in four discontinuing treatment within the first year. Factors influencing adherence span patient-related domains (such as depression, cognitive difficulties and treatment satisfaction), treatment-related aspects (including dosing frequency, side-effect profiles and convenience) and health-system issues (access to specialist centres, educational support and follow-up). Non-adherence not only undermines therapeutic efficacy but also increases relapse rates, healthcare utilisation and long-term costs. Recent efforts have explored behavioural interventions, digital reminders and simplified dosing regimens to bolster both adherence and persistence, emphasising the need for personalised strategies that account for individual barriers and preferences.

Research from Nature Portfolio

Recent work in diverse populations has highlighted treatment satisfaction as a pivotal determinant of adherence to first-line DMTs. In a multi-centre cohort, nearly two-thirds of patients exhibited non-adherence to injectable therapies, with longer disease duration and earlier treatment start dates associated with poorer compliance. Statistical modelling demonstrated that lower satisfaction scores were the sole independent predictor of non-adherence, underscoring the importance of routinely assessing patient experience and preferences to optimise long-term treatment engagement.

Medication Adherence in Multiple Sclerosis Treatment publication trend

The graph below shows the total number of articles in medication adherence in multiple sclerosis treatment across all publications each year (not limited to Nature Index journals).

Technical terms

Disease-modifying therapy (DMT): A pharmacological agent intended to alter the underlying disease course in MS by reducing immune-mediated damage.

Medication adherence: The extent to which a patient’s dosing behaviour corresponds with agreed recommendations from a healthcare provider.

Persistence: The duration of time from initiation to discontinuation of therapy, reflecting sustained treatment use.

Medication Possession Ratio (MPR): A quantitative measure of the proportion of time a patient has access to medication, calculated by dividing days’ supply by days in the observation period.

Expanded Disability Status Scale (EDSS): A standardised scale for assessing neurological impairment and disability progression in MS, ranging from 0 (normal) to 10 (death due to MS).

References

1. Treatment satisfaction with disease-modifying therapy is the only predictor of Adherence among multiple sclerosis patients from Upper Egypt. Scientific Reports (2024).
2. Effect of an educational intervention based on the theory of planned behavior on improving medication adherence in patients with multiple sclerosis treated with injectable disease-modifying drugs: randomized controlled trial. BMC Public Health (2023).
3. Real‐world persistence of multiple sclerosis disease‐modifying therapies. European Journal of Neurology (2024).
4. Factors affecting adherence to disease-modifying therapies in multiple sclerosis: systematic review. Journal of Neurology (2021).