Friday, 21 Sep 2018

You are here

Patients May Not Fill Your Prescription

A new study linking administrative claims and electronic health records (EHRs) shows that nearly 40% of patients fill and take newly prescribed methotrexate (MTX), tofacitinib or biologics. 

Kan et al set out to estimate the extent and predictors of primary nonadherence in rheumatoid arthritis (RA) patients who received new prescriptions for methotrexate, biologics or tofacitinib. They found:

  • 36.8% of patients prescribed methotrexate failed to initiate methotrexate within 2 months;
  • 40.6% of patients newly prescribed biologics/tofacitinib failed to initiate within 3 months.

Predictors for methotrexate primary nonadherence included age, race, region, body mass index, number of active drugs and chronic cormbidities.

Factors associated with biologics/tofacitinib primary nonadherence included age, insurance, and certain comorbidities at baseline. 

Primary nonadherence to methotrexate and biologics/tofacitinib was common in RA patients. It may be possible to predict patients at high risk of primary nonadherence and intervene with measures to promote adherence.

Disclosures: 
The author has no conflicts of interest to disclose related to this subject

Add new comment

More Like This

Managing Comorbidity and Poor Drug Responses

Comorbidity is pervasive and complicates medical care in general. It can be a by-product of aging. It may result from drug therapy or an inciting disease process and may be part of the constellation that defines the primary disorder. A growing body of evidence that suggests that comorbidity has a significant dampening effect on drug responsiveness and, adds to poorer outcomes in patients with inflammatory arthritis.

Opioid Aversion is Augmenting Spinal Steroid Injections

As physicians turn away from opioids, are they resorting to options that may also be unsafe?

The New York Times reports that some physicians are using the anti-inflammatory drug, Depo-Medrol, for intraspinal injections to manage painful spinal and perispinal disorders.

Company Payments to Rheumatologists, Specialists Linked to Increased ACTH Prescriptions

Despite its exorbitant price tag and paucity of supportive clinical evidence, ACTH (corticotropin) sales have increased in the United States. A recent JAMA article examined its use by specialists and found that those who prescribe ACTH (including rheumatologists, nephrologists, neurologists) received corticotropin-related payments from the products sole manufacturer, Mallinckrod.

Veterans Administration Shuns Marijuana as an Option

Cannabis therapy is legal in 30 states in the US, and soon to be legal in Canada and Great Britian, but the US Veterans Administration continues to reject medical marijuana as a therapeutic option - even in states where it is approved.

Predictors of Methotrexate Non-Response

New research from a UK study suggests that nonresponse to oral or subcutaneous MTX was seen in 43% and is predicted by seronegativity, higher disease activity measures and higher anxiety scores.