Extended report
Effect of patient education on adherence to drug treatment for
rheumatoid arthritis: a randomised controlled trial
J Hill, H Bird, S Johnson
Clinical
Pharmacology Unit (Rheumatism Research, University of Leeds), Chapel
Allerton Hospital, Chapeltown Road, Leeds, West Yorkshire LS7 4SA,
UK
Correspondence to: Dr J Hill howbird{at}ulth.northy.nhs.uk
Accepted for publication 23 January 2001
OBJECTIVE
To determine
whether a patient education programme (PE) would improve rates of
adherence to a slow acting antirheumatic drug and to assess any
subsequent effect on patient outcome.
METHODSA randomly
controlled study comprising 100 patients with rheumatoid arthritis (49 control CG; 51 experimental EG) requiring D-penicillamine
(DPA). The same practitioner saw patients on seven occasions, for the
same length of time. The EG received 7 × 30 minute one to one
sessions of PE, while the CG received standard management. The primary
measure of adherence was a pharmacological marker (phenobarbitone)
encapsulated with the DPA assayed at monthly intervals for six months.
Plasma viscosity (PV), C reactive protein, articular index, morning
stiffness, and pain score were used to assess outcome.
RESULTS454 blood
samples were collected and assayed and the pharmacological marker
showed the EG to be significantly more adherent on more occasions than
the CG (p<0.05). Patterns of adherence over time showed that at 12 weeks 86% (38/44) of those in the EG compared with 64% (29/45) of the
CG remained adherent (p=0.01). These trends continued and by the end of
the study 85% (29/34) of the EG compared with 55% (23/42) of the CG
were taking their DPA as prescribed. Fifteen patients (12 from the EG)
experienced side effects requiring study withdrawal and 14 patients
requested study withdrawal (two from the EG). On study entry patients
in the CG had significantly higher levels of PV than the EG and this remained so throughout the research. However, on completion, the health
status of patients in both groups had improved significantly (p<0.01).
CONCLUSIONSPE
significantly increased adherence to DPA and its effects persisted over
a period of six months. No additional clinical benefit was detected in
the EG in comparison with the CG.
© 2001 by Annals of the Rheumatic Diseases
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
This article has been cited by other articles:
-
Berzins, K., Reilly, S., Abell, J., Hughes, J., Challis, D.
(2009). UK self-care support initiatives for older patients with long-term conditions: a review. Chronic Illness
5: 56-72
[Abstract] -
Chambers, S. A., Rahman, A., Isenberg, D. A.
(2007). Treatment adherence and clinical outcome in systemic lupus erythematosus. Rheumatology (Oxford)
46: 895-898
[Full Text] -
Kripalani, S., Yao, X., Haynes, R. B.
(2007). Interventions to Enhance Medication Adherence in Chronic Medical Conditions: A Systematic Review. Arch Intern Med
167: 540-549
[Abstract] [Full Text] -
Treharne, G. J., Lyons, A. C., Hale, E. D., Douglas, K. M. J., Kitas, G. D.
(2006). 'Compliance' is futile but is 'concordance' between rheumatology patients and health professionals attainable?. Rheumatology (Oxford)
45: 1-5
[Full Text] -
Neame, R., Hammond, A.
(2005). Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology (Oxford)
44: 762-767
[Abstract] [Full Text] -
Kurrle, S. E., Cameron, I. D., Quine, S.
(2004). Predictors of Adherence With the Recommended Use of Hip Protectors. Journals of Gerontology Series A: Biological Sciences and Medical Sciences
59: M958-M961
[Abstract] [Full Text] -
Goodacre, L. J., Goodacre, J. A.
(2004). Factors influencing the beliefs of patients with rheumatoid arthritis regarding disease-modifying medication. Rheumatology (Oxford)
43: 583-586
[Abstract] [Full Text] -
Hill, J., Bird, H.
(2003). The development and evaluation of a drug information leaflet for patients with rheumatoid arthritis. Rheumatology (Oxford)
42: 66-70
[Abstract] [Full Text]
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in this journal
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
-
Immunology (including allergy)
-
Connective tissue disease
-
Degenerative joint disease
-
Musculoskeletal syndromes
-
Rheumatoid arthritis
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
