Clinical InvestigationInadequate Therapy Behavior Is Associated to Disease Flares in Patients With Rheumatoid Arthritis Who Have Achieved Remission With Disease-Modifying Antirheumatic Drugs
Section snippets
Setting and Study Population: The Early Arthritis Clinic (February 2004 to Till Date)
All the patients (n = 96) currently attending up to September 2007 the Early Arthritis Clinic of the Instituto Nacional de Ciencias Médicas y Nutrición Salvador-Zubirán, a referral centre for Rheumatic Diseases in México City, and receiving DMARDs (n = 94) were invited to participate. One patient denied. Patients had disease duration of less than a year when first evaluated at the Clinic and no specific rheumatic diagnosis but with RA. Patients were evaluated by the same rheumatologist every 2
Adherence and Persistence With Therapy Over Study Follow-Up
The 93 patients enrolled had mean ± standard deviation (SD) follow-up at the Clinic of 25 ± 12.2 months and neither disease activity nor disability. At study entry, their mean ± SD DAS28 was of 2.1 ± 1.1, HAQ of 0.09 ± 0.22, ESR of 14.2 ± 13 mm/hr and C-reactive protein of 0.54 ± 0.82 mg/dL. All the patients were receiving DMARDs, 2 patients (2.15%) were receiving tumor necrosis factor α antagonists and 26 patients (28%) were receiving corticosteroids.
The whole population completed study
DISCUSSION
The study was prospectively developed in a cohort of patients with early RA who had achieved reasonable disease control after intensive treatment with DMARDs. Adherence and persistence with therapy were defined and measured separately as 2 different constructs6., 31. during a 6-month period, and their impact on disease flares was analyzed.
A substantial proportion of our patients did not take their medication as directed, and adherence and persistence progressively decreased over follow-up.
REFERENCES (40)
- et al.
Medication compliance and persistence terminology and definitions
Value Health
(2008) - et al.
Medication adherence of patients with selected rheumatic conditions: a systematic review of the literature
Semin Arthritis Rheum
(2009) - et al.
Reporting of adherence to medication in recent randomized controlled trials of 6 chronic diseases: a systematic literature review
Am J Med Sci
(2007) - et al.
Medication compliance feedback and monitoring in a clinical trial: predictors and outcomes
Value Health
(2003) - et al.
The mortality of rheumatoid arthritis
Arthritis Rheum
(1994) HEDIS 2006 technical specifications: disease modifying anti-rheumatic drug therapy in rheumatoid arthritis.
(2005)- et al.
Assessment of American College of Rheumatology quality criteria for rheumatoid arthritis in a pre-quality criteria patient cohort
Arthritis Rheum
(2007) - et al.
Treatment continuation in patients receiving biological agents or conventional DMARD therapy
Ann Rheum Dis
(2005) - et al.
Adherence to medication
N Engl J Med
(2005) - et al.
Patient adherence and medical treatment outcomes: a meta-analysis
Med Care
(2002)
Partial medication compliance: the enigma in poor medical outcomes
Am J Manag Care
Patient compliance in rheumatoid arthritis, polymyalgia rheumatica, and gout
J Rheumatol
Noncompliance with arthritis drugs: magnitude, correlates, and clinical implications
J Rheumatol
Factors affecting drug treatment compliance in patients with rheumatoid arthritis
Rheumatol Int
Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus
Clin Rheumatol
Missed medication doses in rheumatic arthritis patients: intentional and unintentional reasons
Arthritis Care Res
Perspective of the patient with rheumatoid arthritis on issues related to missed medication
Arthritis Care Res
Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study
J Rheumatol
Compliance with drug therapy in rheumatoid arthritis. A longitudinal European study
Joint Bone Spine
Assessment of adherence to and persistence on disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis
Med Care
Cited by (0)
- †
Deceased