Prevalence and Associated Factors for Non-adherence in Patients with Rheumatoid Arthritis

Abstract

Objective. To estimate the prevalence of non-adherence to rheumatoid arthritis (RA) medication and identify the associated factors for non-adherence in RA patients. Methods. Among the KORean Observational study Network for Arthritis 3,523 patients who completed a questionnaire about the adherence to RA medication were analyzed. The patients were divided into two groups: 1) adherent group, patients who skipped medication ≤5 days within the past 2 months; and 2) non-adherent group, patients who skipped ≥6 days of medication. The baseline characteristics were compared, and multivariable regression analysis was performed to identify the associated factors for non-adherence. Results. The non-adherent group had 339 patients (9.6%). The common causes of non-adherence were forgetfulness (45.8%), absence of RA symptoms (24.7%), and discomfort with RA medication (13.1%). Younger age (odds ratio [OR] 1.02, p＜0.01) and higher income (OR 1.70, p＜0.01) were associated with an increased risk of non-adherence. Whereas higher functional disability (OR 0.68, p＜0.01) and oral corticosteroid use (OR 0.73, p=0.02) were associated with a decreased risk of non-adherence. The associated factors differed according to cause of non-adherence. Having adverse events (OR 2.65, p=0.02) was associated with the risk of non-adherence due to discomfort with RA medication while a higher level of education (OR 2.37, p=0.03) was associated with the risk of non-adherence due to an absence of RA symptoms. Conclusion. The 9.6% of Korean RA patients were non-adherent to RA medication. The associated factors differed according to the cause of non-adherence. Therefore, an individualized approach will be needed to improve the adherence to RA medication. (J Rheum Dis 2018;25:47-57)

Causal relationship between years of education and the occurrence of rheumatoid arthritis

“…From an aetiological viewpoint, the reasons for the association between years of education and the risk of RA remain unclear. However, plausible mechanisms have been suggested 5. Years of education is known to have a strong environmental component and very little is explained by individual single nucleotide polymorphisms (SNPs).…”

Effect of patient's compliance with nursing instructions on minimizing hepatic encephalopathy

“…In the same line with our results Kuo et al, (2017) [28] reported that hypertension, coronary artery disease or ascites had no effect on adherence level among patients. The same result was contradicted by Kim et al, (2018) [26] who stated that having hypertension or diabetes mellitus were protective factors against non-adherence. This may be due to the different nature of the study.…”

Contribution of Personality Traits, Psychological Factors, and Health-Related Quality of Life to Medication Adherence in Patients with Rheumatoid Arthritis

“…Adherence rates of RA patients vary widely from 30 to 99%. 2 According to the Korean RA cohort KORean Observational study Network for Arthritis (KORONA), 24 the prevalence of adherence to RA treatment was 90.4% among 3523 patients using a self-reported questionnaire designed to identify skipped medication days. However, in another Korean study based on a self-reported questionnaires, medication adherence rate was 45.9%.…”

“…Similar results were reported in another Korean cohort study in which patients in the nonadherence group were less likely to have diabetes mellitus and used less oral corticosteroids than patients in the adherent group. 24 In a Dutch cohort study, concurrent prednisolone use had a positive effect on methotrexate survival. 37 One explanation for these findings may be the relationship between dose of prednisolone and RA disease activity.…”

“…Comorbidities previously have been found to positively impact medication adherence. 24 This study had several strengths and limitations. The strengths were that we comprehensively evaluated the relationship between medication adherence using CQR and personality traits using a five-factor model, psychological factors, and HRQoL in RA patients.…”