Rheumatoid Arthritis Nonadherence is Multifactorial Save

The consequences of medication non-adherence (NA) in rheumatoid arthritis (RA) care are numerous and damaging.  A 6-month prospective cohort study of RA patients shows NA to vary according to drug type and be related to psychological, communicational, logistic, sociodemographic or clinical factors.

In this study treatment adherence was defined as > 80% on both the Compliance Questionnaire in Rheumatology and the Reported Adherence to Medication scale. 6-month adherence was examined by multilevel logistic models adjusted for baseline covariates.

From a total of 180 RA patients (77% women, mean age 61) found the prevalence of adherence to be 59.1%.

• 43.1% for first csDMARD
• 70.4% for the second csDMARD
• 64.4% for bDMARD/tsDMARD.

Biologic use was associated with higher adherence and perceived a higher medication need.

Those on second-line DMARDs had experienced more adverse events than the others.

In the final multivariate model, variables explaining adherence included:

• Type of treatment (second-line DMARDs OR=5.22, and biologics OR=3.76)
• Agreement on treatment (OR=4.57)
• Given information on treatment adaptation (OR=1.42)
• MD perception of patient trust (OR=1.58). These effects were independent of disease activity.

Conclusion Treatment 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.