Beyond Disease Activity, Multiple Factors Predict RA Medication Adherence

Medication adherence in patients with rheumatic arthritis is affected by multilevel factors, according to study findings published online ahead of print in the Annals of the Rheumatic Diseases.

“Treatment adherence in rheumatoid arthritis is far from complete,” wrote a research team from Madrid, Spain. “Psychological, communicational, and logistic factors influence treatment adherence in rheumatic arthritis to a greater extent than sociodemographic or clinical factors.”

The study included 180 patients with rheumatoid arthritis, 77% of whom were female. A third were on their first disease-modifying rheumatic drug (DMARD), a third were on a second-line DMARD, and a third were taking biologic medication. The study looked at treatment adherence, defined as a score greater than 80% on both the Compliance Questionnaire in Rheumatology and the Reported Adherence to Medication scale, over 6 months.

The prevalence of medication adherence, according to the study, was 59.1%.

Patients on biologics had higher adherence and perceived a higher medication need than other patients, researchers reported. Adverse events were most common among patients on second-line DMARDs.

Factors explaining adherence, the study found, were medication type (odds ratios were 5.22 with second-line DMARDs and 3.76 with biologics), agreement on treatment (4.57 odds ratio), having received guidance on treatment adaptation (1.42 odds ratio), and physician perception of patient trust (1.58 odds ratio).

“These effects,” researchers noted, “were independent of disease activity.”

—Jolynn Tumolo

Reference:
Balsa A, García de Yébenes MJ, Carmona L; ADHIERA Study Group. Multilevel factors predict medication adherence in rheumatoid arthritis: a 6-month cohort study. Annals of the Rheumatic Diseases. 2021 November 29;[Epub ahead of print].