Impact of a community pharmacy-based information protocol on multiple sclerosis patients' adherence to their oral treatment with dimethyl fumarate: tecphie, a randomized study vs usual practice (interim results)

OBJECTIVES: Delayed-release dimethyl fumarate (DMF) is an oral compound indicated for the treatment of patients with relapsing-remitting multiple sclerosis (RRMS). This study aims to assess the impact on adherence of specific advice provided by retail pharmacists. METHODS: TECPHIE is a randomized, prospective, multicentre study with two groups of pharmacists, one providing 6 motivational interviews in a period of 9 months in addition to the usual drug delivery and one delivering drug in the usual settings. RESULTS: At the end of recruitment, 109 patients were recruited by 190 pharmacists. An interim intent-to-treat analysis has been performed at 6 months with 31 PATIENTS: 17 without motivational interviews (control group) and 14 with motivational interviews. Mean age was 42 (range, 18−75) years in both groups and disease anteriority was 6 to 7 years on average, with a sex ratio of 4 women for every 1 man. The DMF pill count in the group without motivational interviews was 94.4% (SD 7.3), whereas it was 98.7% (SD 2.7) in the group with motivational interviews (p<0.05). At 6 months, an interim per-protocol analysis was performed with 28 patients : 15 without and 13 with motivational interviews. The DMF pill count in the group without motivational interviews was 95.5% (SD 4.8), whereas it was 99.1% (SD 2. 6) in the group with motivational interviews (p<0.05). CONCLUSIONS: In this interim analysis of RRMS patients treated with DMF, the overall treatment adherence rate at 6 months was high in both groups. However, there was a statistically significant increase in adherence among patients who received motivational interviews by a pharmacist compared with those who did not.