The Rate and Causes of Non-Adherence to Disease Modifying Therapy among Patients with Relapsing Multiple Sclerosis Recorded in Sulaymani City Multiple Sclerosis Clinic

Background: Multiple sclerosis (MS) is a chronic, inflammatory progressive demyelinating disease of the central nervous system. MS is one of the main causes of disability among young adults, and its management is a serious challenge for the healthcare system. And it is a debilitating disease that can partly be controlled with long-term use of disease-modifying therapy (DMT). Adherence of treatment in MS is essential for the benefits of therapies. However, although neurologists are aware of the consequences of non-adherence, they generally spend limited time discussing the importance of treatment adherence with their patients. Treatment for MS focuses on disease management to prevent and treat relapses, manage symptoms, and slow disease progression. Objective: The aim of this study is to find out the rate and causes of non-adherence to disease modifying therapy (DMT) in relapsing multiple sclerosis patients recorded in Sulaimani city multiple sclerosis clinic. Methods: cross-sectional study was conducted, in which about 350 MS patients with relapsing MS recorded in Sulaimani Shar teaching hospital Multiple Sclerosis clinic and 124 patients have been interviewed and evaluated by questionnaires regarding demoFigureic (age, sex, occupation and etc.), clinical data (type of DMT, duration of illness, side effects, missed injection, clinical course of patients, disease progression, missing dose and etc.), causes and barriers of non-adherence to treatment. During the interviews the questionnaire was filled out by the researcher. Data analyzed was performed using SPSS software version 22.0 and P- value. Result: The mean age was 36.89.89 years. The majority of the gender was female (66.1%) and 64.5% of participant were married. The of the total respondents using (Betaferon) (41.1%). there were statistically significant differences between adherent and non-adherent group in type of DMT. However, patients taking (Betaferon) are more belonged to non-adherent group. The main cause for non-compliance was memory problem. The overall adherence was 72.5% according to the first criterion (missed $1 injection or tablet). The degree of adherence among MS patients treated with immunomodulatory drugs are high; however, some patients do not take medications regularly. Conclusion: The adherence rate is acceptable. It is widely known that treatment satisfaction is related to adherence. In our study, patients level of satisfaction was higher with oral treatments. However, oral administration showed a greater lack of adherence. The main cause of lack of adherence was memory problem. In relation to other variables, Side effects of medication, Fear of needles and Tired of taking my medication showed a positive correlation with treatment adherence. Key words: Multiple Sclerosis, Disease Modifying Therapy, Sulaimani, Shar Teaching Hospital