{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T02:20:29Z","timestamp":1787624429631,"version":"build-2736575974"},"reference-count":45,"publisher":"Springer Science and Business Media LLC","issue":"11","license":[{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T00:00:00Z","timestamp":1779753600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"German Federal Joint Committee\u2019s Innovation Fund","award":["01VSF19046"],"award-info":[{"award-number":["01VSF19046"]}]},{"name":"Medizinische Hochschule Hannover (MHH)"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Naunyn-Schmiedeberg's Arch Pharmacol"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    Sustained adherence to disease-modifying therapies (DMTs) is essential for achieving therapeutic benefit in multiple sclerosis (MS). Despite the availability of effective agents, adherence has been reported as variable and often suboptimal in German cohorts, and the relative influence of clinical, demographic, and pharmacological factors remains insufficiently characterised. This study therefore examined predictors of objective adherence to DMTs in people with MS and the association between subjective and objective adherence. We analysed 795 people with MS (PwMS) receiving oral, subcutaneous, or intramuscular DMTs between October 2020 and September 2021. Objective adherence was measured using the Medication Possession Ratio (MPR), and subjective adherence using a visual analogue scale. Permutation-based multivariable analyses (PERMANOVA) were used to examine associations between predefined predictors and MPR. Objective adherence averaged 88.4% (SD 18.0). Subjective adherence was substantially higher, averaging 95.9% (SD 11.6; median 100%), with a pronounced ceiling effect. Therapy-related characteristics were the only consistent predictors of adherence. Oral agents and intramuscular interferon beta-1a achieved comparable adherence (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.90), both exceeding that of subcutaneous therapies (both\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001); within interferons, intramuscular exceeded subcutaneous administration (\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002). Across active substances, glatiramer acetate showed the lowest adherence and teriflunomide, sphingosine-1-phosphate (S1P) receptor modulators, and dimethyl fumarate the highest (all\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001 vs. glatiramer acetate). Demographic, including socioeconomic, and clinical characteristics, comprising age, sex, income, education, employment, MS subtype, disease duration, and disease activity, showed no measurable association with adherence. Subjective and objective adherence correlated only weakly (Spearman\u2019s \u03c1\u2009=\u20090.10;\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.005). Adherence patterns in MS were largely shaped by pharmacological and administration-related factors rather than by patient demographics or clinical profile. The weak correlation between subjective and objective measures supports complementing patient report with objective adherence indicators in routine care.\n                  <\/jats:p>","DOI":"10.1007\/s00210-026-05448-w","type":"journal-article","created":{"date-parts":[[2026,5,26]],"date-time":"2026-05-26T02:21:23Z","timestamp":1779762083000},"page":"17649-17663","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical, demographic, and pharmacological predictors of medication adherence to disease-modifying therapies in multiple sclerosis: a multidimensional analysis of merged survey and claims data"],"prefix":"10.1007","volume":"399","author":[{"given":"Ahkash","family":"Thavarajasingam","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lara Marleen","family":"Fricke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"Krauth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,5,26]]},"reference":[{"key":"5448_CR1","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1046\/j.1442-9993.2001.01070.x","volume":"26","author":"MJ Anderson","year":"2001","unstructured":"Anderson MJ (2001) A new method for non-parametric multivariate analysis of variance. 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The manuscript does not contain identifiable individual participant data or images.","order":3,"name":"Ethics","label":"Consent to publish","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Digital tools were used during the preparation of this manuscript. In particular, an AI-based large language model was used to assist with language editing, structuring, and refinement of text passages. 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