Patient Preference and Adherence (May 2018)
Treatment satisfaction and quality of life in patients treated with fingolimod
Abstract
Claude Mékiès,1 Olivier Heinzlef,2 Béatrice Jenny,3 Anne-Laure Ramelli,4 Pierre Clavelou5 1Clinique des Cèdres, Toulouse, 2Neurology Department, CHI Poissy-Saint-Germain-en-Laye, St Germain-en-Laye, 3alSacEP, CHU Strasbourg, Strasbourg, 4Créteil, 5Service de Neurologie, CHU Gabriel Montpied, University of Auvergne, Clermont-Ferrand, France Background: The development of oral treatments for relapsing–remitting multiple sclerosis (RRMS) may alter patient satisfaction and quality of life (QoL). The aim of this survey was to evaluate treatment satisfaction and QoL in patients treated with fingolimod in everyday clinical practice in France. Methods: Neurologists treating MS in France were invited to participate in the survey by telephone. Each physician was expected to recruit up to six patients with RRMS currently being treated with fingolimod. Enrolled patients were asked to complete the Treatment Satisfaction Questionnaire for Medication (TSQM), the 3-level 5-dimension EuroQoL instrument, as well as specific questions on change in QoL since starting fingolimod. Factors associated with the TSQM score were evaluated using multiple logistic regression analysis. Results: Two hundred and fourteen patients were recruited by 54 neurologists. The mean age of the patients was 41.6±10.0 years, and 73.4% of them were women. During the hospitalization for initiation of fingolimod treatment, 70.1% of patients had received information on MS, 76.6% had received information on fingolimod, and 20.7% had participated in a therapeutic education program. The two variables with the strongest associations with high TSQM scores (≥75) were a positive perception of initial hospitalization (hazard ratio: 10.27) and receiving information on MS during hospitalization (hazard ratio: 5.70). The mean EQ-visual analog scale score was 71.6±16.8. The mean EQ-visual analog scale score was significantly higher in patients satisfied with their treatment (75.8±15.2) compared to those unsatisfied with treatment (66.6±17.2). The proportion of patients who reported an improvement in their capacity to plan for the future was higher in satisfied (72.6%) than in unsatisfied patients (49.5%). Conclusion: The majority of patients treated with fingolimod are satisfied with their treatment. Treatment satisfaction is associated with better self-rated QoL and an improvement of QoL since starting treatment. Keywords: multiple sclerosis, quality of life, treatment satisfaction, patient information, fingolmod, EQ-5D, TSQM, therapeutic education