Increasing Adherence to Multiple Sclerosis Treatment

Program complemented physician's efforts by providing patients with added layer of support


Many patients in Saudi Arabia suffering from multiple sclerosis (MS) had difficulty adhering to their prescribed treatment plan for a number of reasons:

Psychological. The disease affects the psychological status of patients. They often feel alone, needing someone to listen to them and provide assurance. Without this, patients can be less invested in decisions regarding their own treatment.

Awareness. There is a lack of disease and treatment awareness among patients. When patients don’t prioritize their disease, it can mean missing appointments and ignoring medical recommendations, which results in worse medical outcomes and failure to control the disease.

Self-administration. MS patients are often expected to inject the medication themselves. Though this saves time and inconvenience, some patients do not have prior experience administering their own treatment which can lead to non-compliance.

Healthcare providers often don’t have the time to address these individual challenges on their own given their patient load and other responsibilities, requiring other parties to step in to complement their efforts by providing additional support to patients once they left the hospital. To help improve treatment adherence rates among MS patients in Saudi Arabia, Axios partnered with a multinational pharmaceutical company that was eager to do the same.


Axios believes that effective treatment adherence programs are personalized to the needs of individual patients. To design a more effective solution to help patients stay on treatment, Axios turned to its proprietary Patient Needs Assessment Tool (PNAT).

PNAT assesses the risk factors that could lead the patient to stop treatment and helps determine the most effective adherence interventions for that particular patient based on his/her identified risk factors. It was built around the five dimensions of adherence set by the World Health Organization (WHO). It uses a qualitative and semi-quantitative questionnaire to identify and document individual patient risk factors and apprehensions that may lead to poor adherence or discontinuation of treatment. The results are then used to develop a personalized adherence plan targeting these risk factors to support patients in their treatment journey.

In the case of MS patients in Saudi Arabia, in partnership with the Ministry of  Health, local MS patient associations and other parties, the following services were made available to improve treatment adherence and improve a patient’s quality of life:

  • Educational sessions for patients to increase awareness and knowledge about MS and treatment
  • An on-demand support careline to receive and answer patient queries
  • Ongoing treatment reminders and follow-up plans
  • Patient forums to help empower and motivate patients and caregivers
  • Auto-injectors to ease a patient’s injecting process, available upon a patient’s request


Because of the work of Axios and its partners in Saudi Arabia, 55 physicians across the country have referred nearly 600 of their MS patients into the program. Today, the treatment adherence rate among those enrolled has risen to 97%.

As the treatment adherence plan has been customized for each patient, the duration and effectiveness of treatment has also improved. In one illustrative example, it was discovered during a recent patient forum that one woman was so nervous about self-injecting her medication that her hand shook to the point of ruining the medicine by causing bubbles to form. Upon realizing this, Axios staff called the patient every other day to guide her and comfort her throughout the injection process. Now she is empowered to take the injection on her own with confidence.