Background Medication adherence is very important in the treatment of rheumatoid arthritis (RA). However, medication adherence of the patients with RA was not optimal in many of the studies (1–2).
Objectives The purpose of this study was to investigate the medication adherence in tightly controlled RA patients and reasons of non-adherence.
Methods A total of 82 RA patients (65 women and 17 men) who followed regularly in our outpatient clinic were included. Socio-demographic features and medical history were collected. The eight-item Morisky scale (MMAS-8) was used to evaluate adherence to medication. Disease activity score (DAS28), health assessment questionnaire (HAQ), mini mental state examination (MMSE) test and Beck depression inventory (BDI) were evaluated.
Results According to Morisky scale, 34.1%, 15.9% and 50% of our patients were categorized as low, moderate and high adherence, respectively. The most prevalent noticed barriers for adherence were forgetting medication, inadequate information about using instructions, side effects of medications (Table 1). Socio demographic features, duration of disease, type and number of drugs used per day, the route of drug administration, co-morbid diseases, body mass index, smoking and alcohol consumption were not found to be associated with medication adherence, whereas low MMSE and high BDI score were associated with low medication adherence (p=0.009 and p=0.011, respectively). We found that the disease activity was significantly higher in non-adherent cases (p=0.00) (Table 2).
Conclusions Our RA patients who were closely followed had 50% high medication adherence. This rate is quite high compared to other studies using MMAS-8. It should be kept in mind that tight control and adequate communication increase medication adherence but different parameters may also be effective. Assessing cognitive disorders and emotional problems of the patient will be beneficial for improving adherence and controlling disease activity.
Gadallah MA, Boulos DN, Gebrel A, Dewedar S, Morisky DE. Assessment of rheumatoid arthritis patients' adherence to treatment. Am J Med Sci. 2015;349:151–6.
Ferguson A, Ibrahim FA, Thomas V, Weinman J, Simpson C, Cope AP, Scott DL, Lempp H. Improving medication adherence in rheumatoid arthritis (RA): a pilot study. Psychol Health Med. 2015;20(7):781–9.
Disclosure of Interest None declared