Annals of Behavioral Medicine

, Volume 23, Issue 2, pp 125-132

First online:

Injectable medication for the treatment of multiple sclerosis: The influence of self-efficacy expectations and infection anxiety on adherence and ability to self-inject

  • David C. MohrAffiliated withUniversity of California Email author 
  • , Arne C. BoudewynAffiliated withUniversity of California
  • , William LikoskyAffiliated withKaiser Permanente Medical Care Group of Northern California
  • , Ellen LevineAffiliated withCalifornia Pacific Medical Center
  • , Donald E. GoodkinAffiliated withUniversity of California

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The management of many chronic illnesses involves medications that must be injected on a frequent basis. With fewer support resources available, patients are increasingly being obliged to manage injectable medications themselves. Interferon beta-1a (IFNβ-1a), recommended for the treatment of multiple sclerosis (MS), must be injected intramuscularly on a weekly basis. Patients are generally advised and taught to self-inject, if possible. This longitudinal study examined cognitive and affective contributions to the ability to self-inject and adherence to IFNβ-1a over 6 months following initiation of medication. Participants were 101 patients with a relapsing form of MS. Injection self-efficacy expectations, injection anxiety, adherence expectations, method of injection administration, and 6-month adherence to IFNβ-1a were fitted to a path analytic model Pretreatment injection self-efficacy expectations were significantly related to 6-month adherence. This relation was mediated by the patient's ability to self-inject. Patients’experienced level of injection anxiety was related to adherence but not to method of injection.