FACTORS INFLUENCING TREATMENT ADHERENCE IN PATIENTS WITH MULTIPLE SCLEROSIS IN UKRAINE
DOI:
https://doi.org/10.11603/2312-0967.2026.1.15994Keywords:
multiple sclerosis, pharmaceutical care, pharmaceutical assistance, treatment adherence, pharmaceutical professional, martial lawAbstract
The efficacy of disease-modifying therapies (DMTs) for multiple sclerosis (MS) critically depends on treatment continuity. However, under conditions of martial law, this process is significantly complicated by disruptions in pharmaceutical supply chains, heightened psycho-emotional stress among patients, and uncertainty regarding the pharmacist's role in delivering medical and pharmaceutical care.
The aim of the study was to assess the level of treatment adherence among MS patients in Ukraine during wartime, to identify key pharmaceutical, socio-economic, and clinical factors hindering long-term compliance, and to provide a rationale for measures to improve pharmaceutical care for these patients.
Methods. A sociological survey was conducted among 121 patients with a verified MS diagnosis. Adherence was evaluated using the 4-item Morisky-Green Medication Adherence Scale (MMAS-4). Statistical analysis involved descriptive statistics and the nonparametric Pearson’s χ² test for hypothesis testing.
Results. High adherence was observed in 66,1% of respondents. The primary barrier to compliance was forgetfulness (21,5%). Analysis revealed statistically significant associations between adherence level and the source of therapy funding (p < 0,001), disability group (p = 0,022), and patient age (p = 0,042). Patients with Group II disability and those of mature age demonstrated higher treatment discipline. At the same time, factors such as the patient’s location (within Ukraine or abroad, p = 0,17) and internally displaced person status (p = 0,97) showed no significant influence on adherence, indicating strong intrinsic motivation among patients and the resilience of the domestic pharmaceutical supply system.
Conclusions. Low adherence in one-third of patients (33,9%) poses a risk of disease progression and increased disability. The implementation of targeted, personalized pharmaceutical care is justified, with a focus on younger patients and those in the early stages of the disease, incorporating digital reminder tools and psychological support.
References
Eva L, Pleș H, Covache-Busuioc RA, Glavan LA, Bratu BG, Bordeianu A, et al. A comprehensive review on neuroimmunology: insights from multiple sclerosis to future therapeutic developments. Biomedicines. 2023;11(9):2489. https://doi.org/10.3390/biomedicines11092489 DOI: https://doi.org/10.3390/biomedicines11092489
Portaccio E, Magyari M, Havrdova EK, Ruet A, Brochet B, Scalfari A, et al. Multiple sclerosis: emerging epidemiological trends and redefining the clinical course. Lancet Reg Health Eur. 2024;44:100977. https://doi.org/10.1016/j.lanepe.2024.100977 DOI: https://doi.org/10.1016/j.lanepe.2024.100977
Kjetil Bjornevik et al. , Longitudinal analysis reveals high prevalence of Epstein-Barr virus associated with multiple sclerosis. Science 375, 296-301(2022). https://doi.org/10.1126/science.abj8222 DOI: https://doi.org/10.1126/science.abj8222
Miclea A, Bagnoud M, Chan A, Hoepner R. A brief review of the effects of vitamin D on multiple sclerosis. Front Immunol. 2020;11:781. https://doi.org/10.3389/fimmu.2020.00781 . DOI: https://doi.org/10.3389/fimmu.2020.00781
Novak AM, Lev-Ari S. Resilience, stress, well-being, and sleep quality in multiple sclerosis. J Clin Med. 2023;12(2):716. https://doi.org/10.3390/jcm12020716 . DOI: https://doi.org/10.3390/jcm12020716
Kołtuniuk A, Chojdak-Łukasiewicz J. Adherence to therapy in patients with multiple sclerosis-review. Int J Environ Res Public Health. 2022;19(4):2203. https://doi.org/10.3390/ijerph19042203 . DOI: https://doi.org/10.3390/ijerph19042203
Kołtuniuk A, Chojdak-Łukasiewicz J. Beliefs about medicines and the level of intentional non-adherence to treatment among patients with multiple sclerosis treated with first-line drugs. J Clin Med. 2024;13(1):182. https://doi.org/10.3390/jcm13010182 . DOI: https://doi.org/10.3390/jcm13010182
Seitaridou Y, Chamova T, Kamusheva M. Adherence to disease-modifying therapies among patients with multiple sclerosis in Bulgaria-A real world study. Pharmacia. 2024;71:1-7. https://doi.org/10.3897/pharmacia.71.e117681 . DOI: https://doi.org/10.3897/pharmacia.71.e117681
Nehrych O, Pyrohova V, Nehrych T. Quality of life in female patients with multiple sclerosis: the impact of sexual dysfunction. Eur J Gynecol Obstet. 2020;2(3):185-189. Available from: https://www.egojournal.eu/wp-content/uploads/journal/2020/2.3/185/185-189.pdf
Bilousova NA, Nesukai VA, Simahina TV, Dolzhenko MM, Shmatenko OP, Solomennyi AM, et al. Adherence to treatment of patients with coronary heart disease with comorbidities: the impact of socio-economic factors during martial law in Ukraine (second report). Ukr J Mil Med. 2025;6(2):111-124. https://doi.org/10.46847/ujmm.2025.2(6)-111 . DOI: https://doi.org/10.46847/ujmm.2025.2(6)-111
Tkachenko N, Ryzhkova S, Olkhovska A. Analysis of the status of provision of pharmaceutical care to patients with multiple sclerosis in Ukraine. ScienceRise: Pharmaceutical Science. 2025;(3(55)):4-16. https://doi.org/10.15587/2519-4852.2025.329991 . DOI: https://doi.org/10.15587/2519-4852.2025.329991
Samohalska OY, Shmanko OV, Mandziy ZP, Markiv IM, Tiurina VF, Meretska IV, et al. Analysis of pharmacotherapy of arterial hypertension at the inpatient stage. Pharmaceutical Review Farmacevtičnij časopis. 2023;(2). DOI: https://doi.org/10.11603/2312-0967.2023.2.13871 DOI: https://doi.org/10.11603/2312-0967.2023.2.13871
International Pharmaceutical Federation (FIP). The FIP Global Roadmap 2030: Sustainable advancement for pharmacy worldwide. Available from: https://developmentgoals.fip.org/globalroadmap2030/
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors who publish their materials in this journal agree with the following terms:
- Authors reserve the right to authorship of their work and assign to the journal the right to first publish this work under the terms of the Creative Commons Attribution License, which allows other persons to freely distribute the published work with a mandatory reference to the authors of original work and the first publication of work in this journal
. - Authors have the right to make independent extra-exclusive work agreements in the form they are published by this journal (for example, posting work in an electronic repository of an institution or publishing as part of a monograph), provided that the link to the first publication of the work in this journal is maintained.
Journal policy allows and encourages publication of manuscripts on the Internet (for example, in institutions repositories or on personal websites), both before the publication of this manuscript and during its editorial review, as it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the citation of the published work (see The Effect of Open Access).
