Schoor R, Bruce A, Bruce J, Goggin K, Schanfarber B, Bradley-Ewing A, Thelen J, Glusman M, Lynch SG, Strober L, Catley D. Reasons for nonadherence and response to treatment in an adherence intervention trial for relapsing-remitting multiple sclerosis patients.
J Clin Psychol 2018;
75:380-391. [PMID:
30485422 DOI:
10.1002/jclp.22725]
[Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2018] [Revised: 09/26/2018] [Accepted: 10/18/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVES
To explore whether patients in an adherence trial who appeared not to take disease modifying therapy (DMT) for avoidance reasons could be reliably identified, by observational coding, for their main reason of not taking DMT. To determine whether reason groups could be distinguished by clinical and self-report psychological characteristics and intervention outcomes.
METHOD
Participants were multiple sclerosis patients (N = 78, 88.5% female, mean age 45.64) demotivated to take DMT. Audio recordings of the sessions were coded for the main reason of not taking DMT. Reason groups were compared based on patient characteristics and intervention outcomes.
RESULTS
Avoidance and three other reasons for not taking DMT (side effects, cost, and mild course) were reliably identified (κ = 0.88). Patient characteristics failed to distinguish participants in the Avoidance group, which also had poorer outcomes (X2 [2, n = 73] = 6.35, p = 0.036).
CONCLUSIONS
Patients not taking DMT for avoidance reasons may need novel methods to identify them and encourage (re-)initiation.
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