Multilevel factors predict medication adherence in rheumatoid arthritis: a 6-month cohort study

Non-adherence challenges efficacy and costs of healthcare. Knowledge of the underlying factors is essential to design effective intervention strategies.ObjectivesTo estimate the prevalence of treatment adherence in rheumatoid arthritis (RA) and to evaluate its predictors.MethodsA 6-month prospective...

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Vydáno v:Annals of the rheumatic diseases Ročník 81; číslo 3; s. 327 - 334
Hlavní autoři: Balsa, Alejandro, García de Yébenes, Maria Jesus, Carmona, Loreto, Courel, Laura Garrido, Mendizábal, Javier, Restrepo, Juliana, Fábregas, Dolores, Saenz de Buruaga, Joana Atxotegi, Etxebarrieta, Javier Duruelo, Zavaleta, Nathali Rivas, Carmona, Eugenio Chamizo, Chaves, Lara, Rojas, Sara, Sivera, Francisca, Hernández, Laura Casas, Álvarez, Beatriz González, Centeno, Antonio Gómez, Graell, Eduard, Alperi, Mercedes, Holgado, Susana, Morillo, Melania Martinez, Varo, Fermín Medina, Linaza, Alba Pérez, García, Isabel Serrano
Médium: Journal Article
Jazyk:angličtina
Vydáno: England BMJ Publishing Group Ltd and European League Against Rheumatism 01.03.2022
Elsevier Limited
Témata:
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Arthritis, Rheumatoid - psychology
Assessment of Medication Adherence
Biological Products - therapeutic use
Chronic illnesses
Cohort analysis
Comorbidity
Decision making
Disease
Drug stores
Female
health care
health services research
Hospitals
Humans
Logistic Models
Male
Medication adherence
Medication Adherence - psychology
Middle Aged
Multilevel Analysis
outcome and process assessment
patient care team
Patient compliance
Patients
Pharmacy
Physician-Patient Relations
Professionals
Prospective Studies
Questionnaires
Rheumatoid arthritis
Rheumatology
Sociodemographics
patient care team
health services research
outcome and process assessment
health care
ISSN:0003-4967, 1468-2060, 1468-2060
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Shrnutí:Non-adherence challenges efficacy and costs of healthcare. Knowledge of the underlying factors is essential to design effective intervention strategies.ObjectivesTo estimate the prevalence of treatment adherence in rheumatoid arthritis (RA) and to evaluate its predictors.MethodsA 6-month prospective cohort study of patients with RA selected by systematic stratified sampling (33% on first disease-modifying rheumatic drug (DMARD), 33% on second-line DMARD and 33% on biologics). The outcome measure was treatment adherence, defined by a score greater than 80% both in the Compliance Questionnaire in Rheumatology and the Reported Adherence to Medication scale, and was estimated with 95% CIs. Predictive factors included sociodemographic, psychological, clinical, drug-related, patient–doctor relationship related and logistic. Their effect on 6-month adherence was examined by multilevel logistic models adjusted for baseline covariates.Results180 patients were recruited (77% women, mean age 60.8). The prevalence of adherence was 59.1% (95% CI 48.1% to 71.8%). Patients on biologics showed higher adherence and perceived a higher medication need than the others; patients on second-line DMARDs had experienced more adverse events than the others. The variables explaining adherence in the final multivariate model were the type of treatment prescribed (second-line DMARDs OR=5.22, and biologics OR=3.76), agreement on treatment (OR=4.57), having received information on treatment adaptation (OR=1.42) and the physician perception of patient trust (OR=1.58). These effects were independent of disease activity.ConclusionTreatment adherence in RA is far from complete. Psychological, communicational and logistic factors influence treatment adherence in RA to a greater extent than sociodemographic or clinical factors.
Bibliografie:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
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ISSN:0003-4967
1468-2060
1468-2060
DOI:10.1136/annrheumdis-2021-221163