Patient compliance with prescriber's medication instructions was investigated in 178 rheumatoid arthritis patients treated in community practice. The compliance rate in the sample subjects was estimated to be 63.5%. Disease activity, measured objectively with erythrocyte sedimentation rate (ESR) and subjectively by duration of morning stiffness, was a major incentive for adherence to the treatment regimen. Among subjects with active disease (ESR greater than 20 mm in 1 h), the rate of compliance was 73.8%, but this fell to 52.7% among those with a normal ESR (i.e. ESR less than or equal to 20 mm in 1 h). The motivations and perceptions of the subjects concerning their drug therapy also affected compliance. Compliance was however less dependent on perceptions when active inflammation was present.
. Prescribing data indicated that polypharmacy was not common in the community, and that the use of slow acting antirheumatic drugs (SAARDs) and oral corticosteroids was not widespread. At the time of the study 26% of subjects were assayed fully functional-class I of the American Rheumatism Association's (ARA) functional classifications. The functional capacity data provided evidence that the spectrum of rheumatoid arthritis found in the community differed from that found in specialist rheumatology clinics.
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