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E-ISSN : 2148-9696
Crescent Journal of
Medical and Biological Sciences
Apr 2024, Vol 11, Issue 2
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Original Article
Explaining the Barriers to Adherence to Treatment Regimens in Multiple Sclerosis Patients: A Qualitative Content Analysis
Hossein Madani1,2, Alireza Nikbakht Nasrabadi1, Shahrzad Ghiyasvandian1
1Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
2Department of Medical-Surgical Nursing, Abhar School of Nursing, Zanjan University of Medical Sciences, Zanjan, Iran

DOI: 10.34172/cjmb.2024.3386
Viewed : 127 times
Downloaded : 181 times.

Keywords : Barriers, Adherence to the treatment regimen, Multiple sclerosis, Qualitative research, Conventional content analysis
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Objectives: Multiple sclerosis (MS) is a chronic and debilitating disease of the central nervous system and the most common cause of neurological deficits in young adults. Long-term adherence to a treatment regimen is an important challenge for MS patients. This study used a qualitative content analysis approach to explain the barriers to adherence to treatment regimens in MS patients.

Materials and Methods: In this qualitative study, we conducted in-depth semi-structured interviews with 12 MS patients, two parents, two spouses, one child, two experienced nurses in neurology wards, two neurologists, one physiotherapist, one pharmacy technician and MS medications supplier, and one director at MS Society. Data were collected from 2017 to 2020 and analyzed with a conventional content analysis approach.

Results: The analyses yielded four main themes and some related subcategories as the barriers to adherence to treatment regimens in MS patients: "discouraging treatment team" (similar symptoms and multiple differential misdiagnoses, delayed diagnosis and loss of treatment time, misinforming the patient, disparaging and mechanical view of the patient, damage to the trust-based relationship and developing defensive medicine, inappropriate interference of other medical team staff in doctors" job, lack of compassion and disregard for the patient"s educational and medical needs, lack of effort to gain patient trust, doubts about adherence to the treatment regimen, doctor-patient disagreement about the treatment); "disappointing family" (poor cooperation, negative behaviors, misconduct of the spouse"s family, fear and misconceptions); "ignorant society" (hasty judgments, weak culture, economic sanctions); and "personal problems" (devastating unemployment, debilitating economic poverty, disappointment in the future).

Conclusions: Adherence to treatment regimens in Iranian MS patients is associated with individual, family, and social factors and health care providers, such that they can discourage the patients from adhering to their treatment regimens. The focus of the treatment team staff on these factors can help promote adherence to the treatment regimen in MS patients and reduce the recurrence of the disease and readmissions to hospitals.


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