Objective: This study aimed to estimate adherence to methotrexate in patients with rheumatoid arthritis and identify specific nonadherence risk factors. Methods: A cross-sectional study included 111 patients (age mean 56.2±10.6 years, 78.4% female, and disease duration mean 6 (3-13) years). Three adherence self-assessment questionnaires were used: the Compli-ance-Questionnaire-Rheumatology (CQR19), the Medication Adherence Reports Scale (MARS-5), and the Visual Analogue Scale (VAS). We also collected demographic data, disease and treatment characteristics, and anxiety/depression estimation results (Hospital Anxiety and Depression Scale- HADS). Results: Adherence was identified in 48.6% of patients (COR19), 70.3% (MARS-5), and 82.9% of patients in the VAS questionnaire. All three questionnaires displayed a significant positive mutual correlation: CQR19 with MARS-5 and VAS (r =0.364, r=0.329 respectively, p<0.001 for both), between VAS and MARS-5 score (r=0.496, p<0.001). A significant positive prediction was shown for urban residence (0.347 (0.134-0.901), p=0.030), using the MARS-5 scale, female sex (0.264 (0.095-0.730), p=0.010) according to CQR19 and for a dose of methotrexate (0.881 (0.783-0.992), p=0.036) in VAS scale, while negative prediction were shown for comorbidity number (3.062 (1.057-8.874), p=0.039), and depression (1.142 (1.010-1.293), p=0.035) using MARS-5 scale and for older age (1.041 (1.003-1.081), p=0.034) according to CQR19. The use of steroids was a significant positive predictor in all three questionnaires and remained an independent predictor for metho-trexate adherence in multivariant logistic regression. Conclusion: We showed nonadherence to methotrexate in a significant number of patients using all three questionnaires. Concomitant steroid therapy emerged as an independent positive predictor for adherence.

Introduction: Methotrexate (MTX) reduces rheumatoid arthritis activity and ameliorates the long-term functional status in these patients. To achieve this aim, patients need to take their medication regularly. Nevertheless, non-adherence to MTX still remains a considerable issue in the management of rheumatoid arthritis. Objective: This study aimed to estimate the adherence to methotrexate in patients with rheumatoid arthritis and to identify specific non-adherence risk factors. Methods: A cross-sectional study included 111 patients (mean age 56.2 ± 10.6 years, 78.4% female, and mean disease duration 6 years (3–13)). Three adherence self-assessment questionnaires were used: the Compliance-Questionnaire-Rheumatology (CQR19), the Medication Adherence Reports Scale (MARS-5), and the Visual Analogue Scale (VAS). We also collected demographic data, disease and treatment characteristics, and anxiety/depression estimation results (Hospital Anxiety and Depression Scale, HADS). Results: Adherence was identified in 48.6% of patients (COR19), 70.3% of patients (MARS-5), and 82.9% of patients (VAS questionnaire). All three questionnaires displayed a significant positive mutual correlation: CQR19 with MARS-5 and VAS (r = 0.364, r = 0.329, respectively, p < 0.001 for both) and between the VAS and MARS-5 scores (r = 0.496, p < 0.001). A significant positive prediction was shown for urban residence (0.347 (0.134–0.901), p = 0.030) using the MARS-5, female sex (0.264 (0.095–0.730), p = 0.010) according to the CQR19, and for a dose of methotrexate (0.881 (0.783–0.992), p = 0.036) using the VAS, while negative predictions were shown for comorbidity number (3.062 (1.057–8.874), p = 0.039) and depression (1.142 (1.010–1.293), p = 0.035) using the MARS-5 and for older age (1.041 (1.003–1.081), p = 0.034) according to the CQR19. The use of steroids was a significant positive predictor in all three questionnaires and remained an independent predictor for methotrexate adherence in the multivariate logistic regression. Conclusions: We showed non-adherence to methotrexate in a significant number of patients using all three questionnaires. Concomitant steroid therapy emerged as an independent positive predictor for adherence.

Introduction. Rheumatoid arthritis (RA) is accompanied by numerous comorbidities, among which depression and anxiety (D/A) occupy a significant place. Objective. To assess the prevalence of D/A in RA patients and their correlation with quality of life. Methods. The study included RA patients treated at the Rheumatology Clinic of the Military Medical Academy in the period from May to November 2016. Disease activity was assessed by the Disease Activity Score 28-SE (DAS28-SE). Depression/anxiety was determined using the Hospital Anxiety and Depression Scale (HADS Questionnaire) and EuroQoL Five-Dimensional Questionnaire (EQ5D3L Questionnaire) Question 5. Three questionnaires were used to assess quality of life: the general RAND36 (The RAND 36-item Health Survey 1.0) and the specific RAQL and EQ5D3L. Results. On the basis of the HADS Questionnaire, the prevalence of depression was 52% with the average HADS score value of 7.6?3.2, while the prevalence of anxiety was 32% with the mean HADS score value of 5.8?3.8. Question 5 of the EQ5D Questionnaire showed that the prevalence of D/A was 77.4%, of which 71.7% of patients had moderate D/A, while 5.7% of patients had severe D/A. Impairment in all the domains of quality of life was found in some patients, as assessed by all the three questionnaires. The RAQL Questionnaire showed moderate quality of life impairment, with the value of 15.5?7.9. The EQ-VAS value was 58.6?16.0, while the EQ5D index was 0.6?0.3. Univariate linear regression produced a statistically significant negative predictive value of quality of life for the presence of anxiety/depression. Multivariate linear regression showed a statistically significant independent negative predictive value of quality of life, as assessed by the RAQL Questionnaire (p=0.010) and the mental quality of life component of the RAND 36 Questionnaire (p=0.030) for the degree of depression. Conclusion. In RA patients, there is significant prevalence of D/A as well as impairment of quality of life in all domains. The tests performed have shown that quality of life has a statistically significant negative predictive value for the presence of D/A.