Enhancing Adherence and Satisfaction with Disease-Modifying Therapies in Multiple Sclerosis Through Pharmacist-Led Interventions: Interventional Study

المؤلفون

  • Zahraa Abbas Munaf Baghdad Al-Russafa Health Directorate, Iraqi Ministry of Health, Baghdad , Iraq
  • Samer Mohammed Assistant Professor- College of Pharmacy- University of baghdad
  • Gheyath Abd Ali Shallal Al-Gawwam Medical Department, College of medicine, University of Baghdad, Baghdad, Iraq.

DOI:

https://doi.org/10.35516/jmj.v59i3.3080

الكلمات المفتاحية:

Disease modifying therapy, Multiple sclerosis, Clinical Pharmacist Led-Intervention, treatment satisfaction and adherence.

الملخص

Background: Pharmacists are essential in treating MS. Pharmacists' involvement and patient consultation may improve patient adherence and satisfaction.

Aim: To evaluate the influence of pharmacist-led interventions (PLI) on medication adherence and satisfaction in patients with multiple sclerosis receiving disease-modifying therapies (DMTs).

Methods: This study was conducted on patients with relapsing-remitting multiple sclerosis who were receiving DMTs and attended a neurological consultant clinic in the medical city of Baghdad. It was a pre-post-intervention study. Each patient underwent two educational sessions: the first session took place at the beginning of the study, after completing the Arabic version of the treatment satisfaction questionnaire for medication (TSQM-14item) and the Arabic version of the Morisky, Green, and Levine (MGL-4item) medication adherence scales. The second session occurred one month later. The duration of each session ranged from 30 to 45 minutes, during which the patients received educational counselling. Each patient was provided with a formal Arabic pamphlet. This pamphlet contained medical information about the disease and treatment. Subsequently, after two months, the patient completed the identical questionnaires once again.

Results: The participants' average age was 30.64±8.54. PLI had a substantial positive effect on adherence levels, but it did not have a significant impact on medication satisfaction. Significant variations in the educational level and type of treatment were only observed in the changes in treatment satisfaction scores. The degree of response to PLI was not correlated with sociodemographic factors.

Conclusion: The implementation of an educational intervention led by a clinical pharmacist can enhance the adherence of patients with multiple sclerosis; however, the change in treatment satisfaction scores was only a minimal change.

المراجع

Hamid MMA El, Ali NM, Saad MN, Mabrouk MS, Shaker OG. Multiple sclerosis: an associated single-nucleotide polymorphism study on Egyptian population. Network Modeling Analysis in Health Informatics and Bioinformatics [Internet]. 2020;9(1):48. Available from: https://doi.org/10.1007/s13721-020-00255-6

Vargas DL, Tyor WR. Update on Disease-Modifying Therapies for Multiple Sclerosis. Journal of Investigative Medicine [Internet]. 2017 Jun 1;65(5):883–91. Available from:

https://doi.org/10.1136/jim-2016-000339

Patti F. Optimizing the benefit of multiple sclerosis therapy: The importance of treatment adherence. Patient Preference and Adherence [Internet]. 2010;4:1–9. Available from:

https://doi.org/10.2147/ppa.s8230

Buja A, Graffigna G, Mafrici SF, Baldovin T, Pinato C, Bolzonella U, et al. Adherence to therapy, physical and mental quality of life in patients with multiple sclerosis. Journal of Personalized Medicine. 2021;11(7).

Haase R, Kullmann JS, Ziemssen T. Therapy satisfaction and adherence in patients with relapsing-remitting multiple sclerosis: The THEPA-MS survey. Therapeutic Advances in Neurological Disorders. 2016;9(4):250–63.

Twork S, Nippert I, Scherer P, Haas J, Pöhlau D, Kugler J. Immunomodulating drugs in multiple sclerosis: compliance, satisfaction and adverse effects evaluation in a German multiple sclerosis population. Current Medical Research and Opinion [Internet]. 2007 Jun 1;23(6):1209–15. Available from:

https://doi.org/10.1185/030079907X188125

Treadaway K, Cutter G, Salter A, Lynch S, Simsarian J, Corboy J, et al. Factors that influence adherence with disease-modifying therapy in MS. Journal of Neurology [Internet]. 2009;256(4):568–76. Available from:

https://doi.org/10.1007/s00415-009-0096-y

Saiz A, Mora S, Blanco J. Treatment compliance with first line disease-modifying therapies in patients with multiple sclerosis. COMPLIANCE Study. Neurología (English Edition) [Internet]. 2015;30(4):214–22. Available from:

https://www.sciencedirect.com/science/article/pii/S2173580815000346

Becker V, Heeschen V, Schuh K, Schieb H, Ziemssen T. Patient satisfaction and healthcare services in specialized multiple sclerosis centres in Germany. Therapeutic Advances in Neurological Disorders. 2018;11:1–12.

Akash A Chavan, Suraj B Kumbhar, Vikram R Shinde, Akshay A Thorat, Pratik B Jadhav, Arjun R Jadhav, et al. Role of pharmacist in healthcare system. GSC Biological and Pharmaceutical Sciences. 2023;24(1):036–45.

Amaslidou A, Ierodiakonou-Benou I, Bakirtzis C, Nikolaidis I, Tatsi T, Grigoriadis N, et al. [The role of clinical, demographic and psychological characteristics of people with multiple sclerosis in their physical health related quality of life]. Psychiatrike = Psychiatriki [Internet]. 2023 Feb; Available from: https://www.psychiatriki-journal.gr/documents/psychiatry/Amaslidou

Ramanath K V, Santhosh YL. Determining the Impact of Clinical Pharmacist-Provided Patient Education on Quality of Life (QOL) Outcome in Type II Diabetes Mellitus in Rural Population . Challenges and Advances in Pharmaceutical Research Vol 7 [Internet]. 2022 Oct 1;(SE-Chapters):129–41. Available from:

https://stm.bookpi.org/CAPR-V7/article/view/8373

Brola W, Kasprzyk M, Fudala M, Opara J. Palliative care for patients with multiple sclerosis. Medycyna Paliatywna/Palliative Medicine [Internet]. 2013;5(2):41–7. Available from: https://www.termedia.pl/Palliative-care-for-patients-with-multiple-sclerosis,59,21161,1,1.html

Sanii Y, Torkamandi H, Gholami K, Hadavand N, Javadi M. Role of pharmacist counseling in pharmacotherapy quality improvement. Journal of Research in Pharmacy Practice [Internet]. 2016;5(2). Available from:

https://journals.lww.com/jrpp/fulltext/2016/05020/role_of_pharmacist_counseling_in_pharmacotherapy.10.aspx

Mudallal RH, Al-Modallal HM, Alzyoud S, Abdel-Rahman RY. Jordanian Nurse Leaders’ Empowering Behaviors and Contributing Factors as Perceived by Staff Nurses. Jordan Medical Journal. 2023;57(4):359–71.

Garjani A, Rahbar M, Ghafourian T, Maleki N, Garjani A, Salimnejad M, et al. Relationship of pharmacist interaction with patient knowledge of dispensed drugs and patient satisfaction. Eastern Mediterranean Health Journal. 2009;15(4):934–43.

Bejjani A, Hwang S, Iyer S. Impact of a Clinical Pharmacist in a Neurology Clinic Treating Patients with Myasthenia Gravis and Multiple Sclerosis. 2021 [cited 2024 Mar 25]; Available from: https://doi.org/10.21203/rs.3.rs-1002914/v1

Banks AM, Peter ME, Holder GM, Jolly JA, Markley BM, Zuckerman SL, et al. Adherence to Disease-Modifying Therapies at a Multiple Sclerosis Clinic: The Role of the Specialty Pharmacist. https://doi.org/101177/0897190018824821 [Internet]. 2019 Jan 30 [cited 2024 Mar 8];33(5):605–11. Available from:

https://journals.sagepub.com/doi/abs/10.1177/0897190018824821

May A, Morgan O, Quairoli K. Incorporation and Impact of a Clinical Pharmacist in a Hospital-Based Neurology Clinic Treating Patients with Multiple Sclerosis. International Journal of MS Care. 2021;23(1):16–20.

Zuckerman AD, Banks AM, Wawrzyniak J, Rightmier E, Simonson D, Zagel AL, et al. Patient-reported outcomes and pharmacist actions in patients with multiple sclerosis managed by health-system specialty pharmacies. American Journal of Health-System Pharmacy [Internet]. 2023 Nov 15;80(22):1650–61. Available from:

https://doi.org/10.1093/ajhp/zxad180

Glanz BI, Musallam A, Rintell DJ, Chitnis T, Weiner HL, Healy BC. Treatment satisfaction in multiple sclerosis. International journal of MS care. 2014;16(2):68–75.

Fernández O, Duran E, Ayuso T, Hernández L, Bonaventura I, Forner M. Treatment satisfaction with injectable disease-modifying therapies in patients with relapsing-remitting multiple sclerosis (the STICK study). PLoS ONE. 2017;12(10):1–12.

Vermersch P, Hobart J, Dive-Pouletty C, Bozzi S, Hass S, Coyle PK. Measuring treatment satisfaction in MS: Is the treatment satisfaction questionnaire for medication fit for purpose? Multiple Sclerosis [Internet]. 2017 Apr 1 [cited 2024 Mar 8];23(4):604–13. Available from: http://www.sagepub.co.uk/

Eagle T, Stuart F, Chua AS, LaRussa A, Leclaire K, Cook SL, et al. Treatment satisfaction across injectable, infusion, and oral disease-modifying therapies for multiple sclerosis. Multiple sclerosis and related disorders. 2017 Nov;18:196–201.

Wang G, Ann R, Fox RJ, Tyry T, Co SS, Cutter GR, et al. Treatment satisfaction and bothersome bladder , bowel , sexual symptoms in multiple sclerosis. 2018;20(August 2017):2017–9.

Thach A V., Brown CM, Herrera V, Sasane R, Barner JC, Ford KC, et al. Associations between treatment satisfaction, medication beliefs, and adherence to disease-modifying therapies in patients with multiple sclerosis. International Journal of MS Care. 2018;20(6):251–9.

Alhazzani A, Alqahtani M, Alamri N, Sarhan L, Alkhashrami S, Alahmarii M. Treatment satisfaction and adherence to medications among multiple sclerosis patients in Saudi Arabia. Egyptian Journal of Neurology, Psychiatry and Neurosurgery. 2019;55(1).

Algawwam G, Mikhael EM, Ali AM, Ghazi DM, Shihab TF. Assessing the adherence to different disease-modifying treatment among iraq relapsing-remitting multiple sclerosis patients. International Journal of Pharmaceutical Research [Internet]. 2020 Jan 2 [cited 2024 Mar 8];12:1804. Available from:

https://openurl.ebsco.com/contentitem/doi:10.31838%2Fijpr%2F2020.SP1.276?sid=ebsco:plink:crawler&id=ebsco:doi:10.31838%2Fijpr%2F2020.SP1.276

Yahya RN, Kasim AA, AlGawwam G, Fawzi HA. Treatment satisfaction with disease-modifying therapy in relapsing-remitting multiple sclerosis in Iraq. International Journal of Research in Pharmaceutical Sciences. 2018;9(3):836–43.

Ting J, Liu Y, Petrillo J, Giannattasio G, Sabatella G. Treatment Satisfaction With Disease Modifying Therapies In Multiple Sclerosis: A Systematic Review of Studies Using The Treatment Satisfaction Questionnaire For Medication (Tsqm). Value in Health [Internet]. 2015 Nov 1;18(7):A760–1. Available from:

https://doi.org/10.1016/j.jval.2015.09.2484

Abbood SK, Assad HC, Al-Jumaili AA. Pharmacist intervention to enhance postoperative fluid prescribing practice in an Iraqi hospital through implementation of NICE guideline. Pharmacy Practice. 2019;17(3):1–8.

Mahdi MZ, Anwer ZM. Evaluating the Impact of Pharmacist Counselling for Asthmatic Children at Karbala Teaching Hospital for Children: An Interventional Prospective Study (Conference Paper)#. Iraqi Journal of Pharmaceutical Sciences. 2021;30(2):22–30.

Abbas JK, Al-Metwali BZ. The impact of pharmacist behavioral intervention on antibiotics prescribing in pediatric wards. F1000Research 2023 12:458 [Internet]. 2023 May 2 [cited 2024 Mar 8];12:458. Available from: https://f1000research.com/articles/12-458

Khazal AA, Jamal MY. The Role of Clinical Pharmacist in Reducing Drug Related Problems in Decompensated Liver Cirrhosis Patients. Iraqi Journal of Pharmaceutical Sciences. 2023;32(2):1–8.

Mikhael EM, Hassali MA, Hussain SA, Nouri AI, Shawky N. Pharmacist-led interventional programs for diabetic patients in Arab countries: A systematic review study. International Journal of Diabetes in Developing Countries [Internet]. 2019;39(4):600–10. Available from:

https://doi.org/10.1007/s13410-019-00720-7

Al-jumaili AA, Al-rekabi MD, Doucette W, Hussein AH. Factors influencing the degree of physician-pharmacist collaboration within Iraqi public healthcare settings Factors influencing the degree of physician – pharmacist collaboration within Iraqi public healthcare settings. 2017;(February).

Liberato ACS, São João TM, Jannuzzi FF, Landaas EJ, Wongchareon K, Rodrigues RCM. Treatment Satisfaction Questionnaire for Medication (TSQM version 1.4): Ceiling and Floor Effects, Reliability, and Known-Group Validity in Brazilian Outpatients With Hypertension. Value in Health Regional Issues. 2020 Dec 1;23:150–6.

Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, et al. Health and Quality of Life Outcomes Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease [Internet]. 2004. Available from:

http://www.hqlo.com/content/2/1/12

Shahrbabaki ME, Ahmadipour H, Yousefi N, Divsalar P. Tit Treatment Satisfaction Questionnaire for Medication (TSQM Version II): A Psychometric Properties Analysis. International Journal of High Risk Behaviors and Addiction. 2022;11(4):1–12.

Awwad O, AlMuhaissen S, Al-Nashwan A, AbuRuz S. Translation and validation of the Arabic version of the Morisky, Green and Levine (MGL) adherence scale. PLoS ONE. 2022 Oct 1;17(10 October).

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Medical Care. 1986;24(1):67–74.

Mékiès C, Heinzlef O, Jenny B, Ramelli AL, Clavelou P. Treatment satisfaction and quality of life in patients treated with fingolimod. Patient Preference and Adherence. 2018;12:899–907.

Mohammed S, Alhilali D, Mubder N. Perception, Benefits, and Factors Affecting the Quality of Hospital Training Course for Pharmacy Students: A Qualitative Study with Recently Graduated Pharmacy Students. Open Access Macedonian Journal of Medical Sciences [Internet]. 2022 Oct 23;10(E SE-Public Health Education and Training):1801–6. Available from:

https://oamjms.eu/index.php/mjms/article/view/10819

التنزيلات

منشور

2025-07-06

كيفية الاقتباس

Abbas Munaf, Z. ., Mohammed, S., & Abd Ali Shallal Al-Gawwam, G. . (2025). Enhancing Adherence and Satisfaction with Disease-Modifying Therapies in Multiple Sclerosis Through Pharmacist-Led Interventions: Interventional Study. المجلة الطبية الأردنية, 59(3). https://doi.org/10.35516/jmj.v59i3.3080

إصدار

القسم

Articles