Adherence is defined as the extent to which a person’s behaviour corresponds with the agreed prescription*4 | ||||
Overarching principles | LoA | |||
A | Adherence impacts the outcomes of people with RMDs. | 98.6 | ||
B | Shared decision making is key, since adherence is a behaviour following an agreed prescription. | 95.8 | ||
C | Adherence is influenced by multiple factors. | 97.5 | ||
D | Adherence is a dynamic process that requires continuous evaluation. | 96.2 | ||
Points to consider | LoE | GR | LoA | |
1 | All HCPs involved in the management of people with RMDs should take responsibility for promoting adherence. | 5 | D | 98.6 |
2 | Effective patient-health professional communication should be applied to enhance adherence. | 5 | D | 99.4 |
3 | Barriers and facilitators of adherence of a specific patient to a specific prescription should be appropriately evaluated. | 5 | D | 95.2 |
4 | Patient education should be provided for people with RMDs as an integral part of standard care. | 1A | A | 95.9 |
5 | Care should be tailored to patient preferences and goals to enhance adherence. | 5 | D | 98.4 |
6 | Adherence should be discussed regularly based on open questions and particularly when disease is not well controlled. | 5 | D | 98.9 |
7 | The HCP should explore which factors might negatively influence adherence, including: opportunity (eg, availability or cost), capability (eg, memory problems), motivation (eg, concerns). | 5 | D | 93.8 |
8 | Together with the patient, the HCP should tailor the approach to overcome individual barriers to adherence, for example, simplifying the regimen, using reminders, providing education, discussing the patient’s beliefs on treatments. | 5 | D | 97.9 |
9 | When specific expertise or interventions for adherence are needed, they should be made available to patients. | 5 | D | 97.7 |
*Prescription in this context refers to any instruction (mostly written) from a physician or health professional in rheumatology stating the form, dosage and kind of treatment, including but not limited to medications, exercises, diets and follow-up appointments.
GR, grade of recommendation20 ; HCP, healthcare providers; LoA, Level of agreement of task force members on a numeric rating scale from 0 (no agreement) to 10 (perfect agreement); LoE, level of evidence; RMDs, rheumatic and musculoskeletal diseases.