Introduction and purpose: Multiple sclerosis (MS) is a chronic, autoimmune, inflammatory disease of the central nervous system that remains an incurable disease. Pharmacological treatment aims to minimize the debilitating symptoms, slow disease progression, and protect the quality of life. Medication adherence is one of the main success factors in the treatment of this chronic disease, which is influenced by various factors. This study aimed to determine the relationship between depression and medication adherence in patients with MS. Methods: This descriptive-analytical study was conducted on 200 patients with MS referred to Bu Ali Sina Hospital and Multiple Sclerosis Association in Qazvin City, Iran, in 2023. Patients were included in the study following convenience sampling. Data were collected by demographic checklist, Morisky Medication adherence Scale (MMAS-8), and Beck Depression Inventory (BDI). Bivariate and multivariate logistic regression analyses were carried out using the SPSS-v25 software. Results: The mean and standard deviation of the scores of medication adherence and depression were 6.93±1.66 and 36.19±10.26, respectively. In 23.3% of the participants, the level of medication adherence was low, and depression was at moderate (30.5%) and severe levels (69.5%). In the multivariate regression analysis, with an increase in depression scores, the odds of non-adherence to treatment increased by 1.72 times, and patients suffering from more severe depression had lower medication adherence (P<0.0001). The odds of non-adherence to treatment in patients receiving oral medications compared to those receiving injectable medications was 2.144 times higher (P<0.039), and in unemployed patients compared to employed patients, it was 0.286 times higher (P<0.046). Conclusion: Depression has a significant negative impact on medication adherence in MS patients. Employment status and type of prescribed drugs are related to medication adherence in these patients. Therefore, the role of these factors should be taken into account when designing educational, caring, and supportive interventions.

Aim: The aim of this paper is to review studies related to sodium restriction and adherence to this restriction in patients with heart failure.Background: In the last decade, there has been a dramatic increase in the prevalence and incidence of chronic heart failure. Non-pharmacological and non-surgical therapies in the management of chronic heart failure play an important role, and low sodium intake, by reducing fluid retention, improves symptoms and prevents worsening of the disease, but adherence to nutritional regimes is often less than adherence to medications.Method: We reviewed studies published over the recent 15 years regarding sodium restriction in patients with heart failure. These were searched out through scientific databases, including PubMed and Science Direct by the keywords adherence, chronic heart failure, low-sodium diet, sodium restriction, low salt diet and their Persian equivalents.Findings: In the reviewed studies, sodium intake assay and patient's adherence to sodium restriction were different. Although sodium restriction is known as the basic management of heart failure, butthere are not consensus about its usefulness. It was also found that there is no specific guidelines for sodium restriction in heart failure, and that a small percentage of patients follow sodium restriction. Few studies have been conducted regarding related factors of adherence to the sodium restriction diet in patients with heart failure. Also, non-pharmacological methods including education and counseling have not been successful in improving patients’ adherence.Conclusion: Further research with higher methodological quality, larger sample size and the use of appropriate and accurate approach to measure sodium intake is needed. To achieve a sodium restriction diet is possible, but difficult. Although, there is no consensus on the exact amount of the reduction of daily sodium intake, but seems that reduction in sodium intake can improve symptoms and quality of life in patients with heart failure. Theory-based and family-based interventions may be able to help improving patients’ adherence to sodium restriction diet, although more studies are essential to be conducted.