Disease-modifying medications for MS rely on the individual to be "adherent" for maximum effectiveness. In this case, adherence means that you take your medication as it is prescribed, without skipping doses or allowing too much time to lapse between doses. Individuals must give frequent injections at home or come into a medical facility routinely for an infusion. If a person follows instructions, the medications have a better chance of working.
When you think of "adherence tips" you may be expecting to see a list of ideas which includes using sticky notes as reminders to give yourself an injection or placing your syringe next to your toothbrush, so that you link the injection to something else that you do routinely. However, adherence is largely psychological, especially when your task (in this case an injection or infusion) is not exactly pleasant. Let's face it - no one has to remind us that there is ice cream for dessert or that you don't have to go to the office on Saturday. The good news is there are a some things that you can do to get your subconscious on board to help you stick to your medication schedule.
The following tips will help you get in the right mindset to be adherent to your MS treatments:
Believe in the Treatment
A recent study in the Journal of Neurological Science showed that the most common reason for people on MS therapies to discontinue treatment is that the patient does not perceive the treatment to be working. This perception is easy to have because the disease-modifying treatments don't improve anything on the surface. In fact, you often feel worse than you did before starting the treatment, due to side effects like flu-like symptoms, injection site reactions and increased fatigue. Despite the inconvenience and the discomfort, you need to tell yourself that the medication is working to lower your chances of having a relapse.Give it a Year
The same study also showed that most people who discontinue treatment within the first year. For some of the medications (like Copaxone) it may take up to nine months to reach full effectiveness. Other medications, like Avonex, may take six months before the side effects plateau. If you stick with your disease-modifying therapy for a least a year, there is a good chance that the side effects will disappear (or at least become more bearable) and the experience of giving yourself an injection will become far less difficult than at the beginning. Make it through a year and you will have made it "over the hump" psychologically and physically, and be able to stay on treatment as long as it is indicated.Believe in Yourself
Another study reported that "self-efficacy" predicted treatment adherence among MS patients. Self-efficacy is a measure of how much a person believes that he or she has the skills and resources to accomplish something. The more someone believed that he or she could take control of their MS and their treatment, the more likely they were to stay on treatment. To increase your confidence, focus on the benefits of the treatments, create a plan now to deal with side effects and other challenges and visualize yourself being successful on treatment. Be proud that you are brave enough to give yourself an injection or face another infusion.Hope
The same study also showed that the more hopeful people were, the more likely they are to stay on treatment. Become hopeful about your MS. New research is coming out every day and new drugs and treatments are in development. The current treatments have been shown to be effective in long-term studies.
Have a Supportive Doctor
People are also more likely to stay on MS treatments if their doctor is supportive of the treatment and the patient. Your doctor should feel like a partner in your management of your MS. Be sure to see your doctor regularly and voice any concerns or questions that you have.Sources:
Clerico M, Barbero P, Contessa G, Ferrero C, Durelli L. Adherence to interferon-beta treatment and results of therapy switching. J Neurol Sci. 2007 Aug 15;259(1-2):104-8. Epub 2007 Mar 21.
Fraser C, Hadjimichael O, Vollmer T. Predictors of adherence to Copaxone therapy in individuals with relapsing-remitting multiple sclerosis J Neurosci Nurs 2001 Oct;33(5):231-9
