Multiple sclerosis (MS) patients who adhere strictly to their medication pay more but stay healthier in the long run than those who don’t, a study found.
The study, “Measuring Adherence and Outcomes in the Treatment of Patients With Multiple Sclerosis,” appeared in the Journal of the American Osteopathic Association. It took place at Pennsylvania’s Geisinger Health System.
Researchers at Liberty University College of Osteopathic Medicine in Lynchburg, Virginia, analyzed data from 2004 to 2013, including electronic health records, insurance claims and self-reported medication adherence. They based their assessment of health outcomes on inpatient admission, emergency room visits, outpatient appointments and healthcare costs.
In total, 681 participants answered questionnaires about medication adherence and disease outcomes, including the Multiple Sclerosis Impact Scale (which measures the impact of MS on day-to-day life in the past two weeks) and the Kurtzke Expanded Disability Status Scale (EDSS, a rating of disability’s degree in MS). Also used was the Treatment Satisfaction Questionnaire for Medication to assess satisfaction with the medication taken.
Patients who took their medicines most rigorously reported 14 percent less severe physical impact of MS, and 17 percent less severe psychological impact than those with low adherence. These patients also reported a 12 percent decrease in disability level, and believed their treatment plan was 7 percent more effective.
However, the total overall costs were higher for patients who adhered to their doctor’s orders.
“Payers often look at near-term improvement to determine whether a treatment is effective and worth the cost,” Dr. Carl Hoegerl, the study’s co-author and a neurologist at Liberty University, said in a press release. “But the case for MS treatment becomes evident when you see that the rate of decline becomes much slower and less severe.”
Hoegeri said it’s more difficult to detect improvements in health outcomes for MS than for other chronic illnesses. This is partly because the only test for changes in disease status is brain imaging, which is expensive and not done routinely. Furthermore, brain imaging only detects new lesions following a relapse, which cannot be compared to previous or future imaging in a quantifiable way.
In fact, no simple tests exist for measuring disease severity in MS as there are in other chronic diseases, making it difficult to determine whether treatment benefits justify their cost.
“As an osteopathic physician, I’m focused on partnering with patients to achieve their health goals, which for most MS patients involves maintaining their physical functions for as long as possible,” said Hoegerl.