Table 2.

Barriers to long-term adherence and potential solutions

Barrier	Potential solutions
Treatment fatigue	Educate patients on the implications of taking treatment breaks or stopping therapy Discussion forums to remotivate patients Reeducate patients regarding treatment expectations Revisit lifestyle issues
Injection-site reactions/ local side effects	Nurse education on side-effect management Guidelines for the management of injection-site reactions Reinforcement of correct injection technique/need to rotate injection sites to avoid injection-site reactions
Depression	Screening for depressive symptoms Treatment of depressive symptoms
Multiple sclerosis-related cognitive decline	Support mechanisms Regular education forums Reminders of treatment timing (eg, SMS alerts) Involvement of family/carer in treatment discussions

Abbreviation: SMS, short message service, ie, text message.