Methotrexate Nonadherence is Common Save

Researchers from Belgium studied patient adherence to MTX (given orally or via injection) in 129 rheumatoid arthritis (RA) patients over a 16-week period using an electronic monitoring system and two validated adherence questionnaires.

Full adherence was noted in 58% of RA patients, and 75 % skipped at most one dose during 16 weeks.

A better mental health status and suffering from comorbidities had a positive effect on adherence, while living alone had a negative effect. These three predictors explained 30% of the variance in MTX adherence.

Patient-reported adherence by VAS correlated modestly with adherence using the electronic monitoring system (r = 0.552, p = 0.01). Higher adherence rates were observed in RA patients treated with MTX.

Another multicenter study from the United Kingdom showed similar results with 13.5% of patients reporting they had forgotten to take the drug for an average of two weeks, and 25% for an average of 2.5 weeks in the previous year. Participants were more likely to reveal this to a nurse than a doctor.  This was often related to MTX side effects, seen in 57% to 86% of those surveyed. Most frequent side effects were fatigue (53%), nausea (38%), mouth ulcers (23%), and hair loss (23%). (Citation source http://buff.ly/1T4TXq2)

Patient adherence continues to be a challenge in the complex management of RA patients.