Background Adherence to rheumatoid arthritis (RA) treatment is essential for therapeutic success.Factors contributing to therapy adherence and their consequences are under debate.
Objectives To investigate the relationship between therapy adherence and disease activity as well as patients' quality of life.
Methods The survey included a representative, nationwide sample of German physicians specialized in RA and patients with RA. The physician questionnaire assessed disease activity (DAS28), patients' adherence to therapy and medical prescriptions. The patient questionnaire assessed quality of life (SF-12), health education literacy (i.e., the understanding and use of medical information, HELP), activities of daily living (MDHAQ), fatigue (EORTC QLQ-FA13) and patients' listings of their medications. Adherence was assessed with a combined measure of physician rating (1= very adherent, 0 = less adherent) and the match between physicians' prescriptions and patients' accounts of their medications (1 = perfect match, 0 = no perfect match). Three groups of patients could be distinguished: high (very adherent according to physician and perfect medication match, n=180), medium (either high physician rated adherence or perfect medication match, n=279), and low (0 in both adherence criteria) (n=205). An ANOVA was used to analyze differences in continuous variables among the three groups.
Results 671 pairs of patient and physician questionnaires were analyzed. Mean patients' age (73% female) was 60 years (SD=12). At the time of assessment, 67.2% the patients showed low disease activity (DAS28 <3,2), 28.8% moderate disease activity (DAS28 3,2 to 5,1), and 4.0% high disease activity (DAS28 >5,1). There was no relation between adherence and demographic variables. However, it was related to disease activity, numerous psychosocial variables and the number of prescribed medications (Table 1).
Conclusions This study showed that patient adherence to therapy was associated with less disease activity and higher levels of quality of life. Adherence was also dependent on the total number of prescribed medications. The effects were consistent across different psychosocial domains. The findings may help to detect patients who are at risk not to comply with treatment and eventually to optimize patient education and counseling.
Rauscher V et al.: J Rheumatol. 2015 Jan 15. pii: jrheum.140982.
Zwikker HE et al.: 2014 Nov 25;8:1635–45. doi: 10.2147/PPA.S66849. eCollection 2014.
Gadallah MA et al.: Am J Med Sci. 2014 Dec 3
Disclosure of Interest None declared
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