Document Detail


Gender differences in self-reported symptom awareness and perceived ability to manage therapy with disease-modifying medication among commercially insured multiple sclerosis patients.
MedLine Citation:
PMID:  20331325     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Multiple sclerosis (MS) is a chronic, neurodegenerative inflammatory disease that affects approximately 400,000 Americans, the majority of whom are female. Although MS prevalence is higher among females, males are more likely to have a more progressive clinical course. For both genders, use of disease-modifying medications (DMMs) in the clinical management of MS is pivotal in altering the natural course and diminishing progressive disability over time. OBJECTIVES: To evaluate gender differences in self-reported symptom awareness and perceived ability to manage therapy among MS patients taking a DMM. METHODS: During February 2008, a self-administered, 42-item survey was mailed to 4,700 commercially insured patients taking a DMM to treat MS. Survey items measured self-reported clinical characteristics, symptom awareness, and perceived ability to manage therapy. Bivariate analyses assessed associations of gender with other predictor and outcome variables, including demographic characteristics, clinical disease characteristics, specific DMM used at the time of the survey, self-reported symptom awareness, and perceived ability to manage therapy. Logistic regression analyses further assessed the associations of gender with symptom awareness and perceived ability to manage MS after adjustment for relevant covariates (age at diagnosis, educational level, income, current DMM, type of pharmacy where drug was dispensed, frequency of flare-ups, and clinical course of disease). RESULTS: The response rate was 44.1% (n = 2,074). Of the 2,022 respondents with useable surveys, 80.6% were female; 82.3% had relapsing remitting MS; and 83.1% were taking one of the most commonly used DMMs (intramuscular interferon beta-1a 33.4%, subcutaneous interferon beta-1a 15.9%, and glatiramer acetate 33.8%). Compared with female patients, males were older and a greater proportion had a more progressive clinical course of disease. In multivariate models, female patients were more likely than males to report recognition of a relapse/exacerbation (odds ratio [OR] = 1.37, 95% CI = 1.03-1.82) and to report knowing what to do when experiencing a relapse/exacerbation (OR = 1.34, 95% CI = 1.01- 1.77) or if they missed a dose of medication (OR = 1.78, 95% CI = 1.08-2.43). Females were also more likely to report awareness of treatment options (OR = 1.48, 95% CI = 1.07-2.07) and to think that DMMs were helping their MS (OR = 1.32, 95% CI = 1.02-1.77). CONCLUSIONS: Female MS patients report better awareness of disease symptoms and have more positive perceptions of their ability to manage therapy with DMMs than male MS patients. These findings suggest that male MS patients may require additional education and support to manage their disease and therapy needs. Knowledge of these gender differences potentially could help managed care organizations to improve therapy adherence by guiding gender-specific patient support programs.
Authors:
Anna Vlahiotis; Rebecca Sedjo; Emily R Cox; Thomas E Burroughs; Amy Rauchway; Rebecca Lich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of managed care pharmacy : JMCP     Volume:  16     ISSN:  1083-4087     ISO Abbreviation:  J Manag Care Pharm     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-24     Completed Date:  2010-05-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9605854     Medline TA:  J Manag Care Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  206-16     Citation Subset:  IM    
Affiliation:
Express Scripts, Inc., 1 Express Way, St. Louis, MO 63121, USA. avlahiotis@express-scripts.com
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MeSH Terms
Descriptor/Qualifier:
Adjuvants, Immunologic / pharmacology,  therapeutic use*
Adolescent
Adult
Data Collection
Female
Health Knowledge, Attitudes, Practice*
Humans
Logistic Models
Male
Middle Aged
Multiple Sclerosis / drug therapy,  physiopathology*
Multiple Sclerosis, Relapsing-Remitting / drug therapy,  physiopathology
Multivariate Analysis
Patient Education as Topic
Sex Factors
United States
Young Adult
Chemical
Reg. No./Substance:
0/Adjuvants, Immunologic

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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