MEDICATION ADHERENCE STATUS AMONG RHEUMATOID ARTHRITIS PATIENTS

Authors

  • Ai Sim Wee Faculty of Pharmacy, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, 50300 Kuala Lumpur, Malaysia
  • Mohd Shahrir Bin Mohamed Said
  • Adyani Bt Md

Keywords:

Rheumatoid arthritis, medication adherence, medication beliefs, DMARD

Abstract

Objective: Rheumatoid arthritis (RA) is a common disease affecting about 5 in 1,000 people in Malaysia. Medication adherence among RA patients can be as low as 30% and non-adherence of disease modifying anti-rheumatic drugs (DMARD) may result in irreversible joint damage. This study aimed to assess adherence rates and to identify potential factors influencing adherence.

Methods: A cross-sectional study was conducted at Rheumatology Clinic of a tertiary hospital for 8 w from May to June 2014. A total of 51 RA patients using DMARD were recruited in this study. Researcher-assisted questionnaires were utilized. The study assessed adherence by using Compliance Questionnaire on Rheumatology (CQR5) and data retrieved from pharmacy dispensing records which were measured using Medication Possession Ratio (MPR). Questionnaires to assess beliefs about medicines and satisfaction about medicine information were also used. Subsequently, associations between adherence and demographics, socioeconomics, medication, disease and patient-related factors were determined.

Results: The response rate was 75%. Depending on the instruments used, 75% (CQR5) and 60% (MPR) of the patients were adherent to DMARD. Non-adherence was not associated with demographic, socioeconomic and clinical characteristics, satisfaction about medication information and medication concerns. Beliefs about the necessity of medication (r = 0.372; p = 0.007) and necessity-concerns differential (r = 0.439; p = 0.001) were moderately associated with adherence.

Conclusion: Patient-related factor was associated with medication adherence in our study population. The necessity-concerns differential of medication beliefs may serve as a possible screening tool for non-adherence or target for adherence-improving intervention among RA patients.

Keywords: Rheumatoid arthritis, Medication adherence, Medication beliefs, DMARD

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References

World Health Organization. Adherence to long-term therapies: evidence for action. Geneva, Switzerland; 2003.

Gabriel SE. The epidemiology of rheumatoid arthritis. Clin Rheum Dis 2001;27:269-81.

Woolf AD, Pfleger B. Burden of major musculoskeletal conditions. Bull World Health Organ 2003;81:646-56.

Kitas GD, Gabriel SE. Cardiovascular disease in rheumatoid arthritis: state of the art and future perspectives. Ann Rheum Dis 2011;70:8-14.

Van den Bemt BJ, Zwikker HE, van den Ende CH. Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature. Expert Rev Clin Immunol 2012;8:337-51.

Van den Bemt BJ, van den Hoogen FH, Benraad B, Hekster YA, van Riel PL, van Lankveld W. Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease-modifying antirheumatic drugs. J Rheumatol 2009;36:2164-70.

Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986;24:67-74.

de Klerk E, van der Heijde D, Landewé R, van der Tempel H, van der Linden S. The compliance-questionnaire-rheumatology compared with electronic medication event monitoring: a validation study. J Rheumatol 2003;30:2469-75.

Horne R, Weinman J. Patients' beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness. J Psychosom Res 1999;47:555-67.

Curkendall S, Patel V, Gleeson M, Campbell RS, Zagari M, Dubois R. Compliance with biologic therapies for rheumatoid arthritis: do patient out-of-pocket payments matter? Arthritis Rheum 2008;59:1519–26.

Pasma A, van't Spijker A, Hazes JMW, Busschbach JJV, Luime JJ. Factors associated with adherence to pharmaceutical treatment for rheumatoid arthritis patients: a systematic review. Semin Arthritis Rheum 2013;43:18-28.

Hughes LD, Done J, Young A. A 5 item version of the Compliance Questionnaire for Rheumatology (CQR5) successfully identifies low adherence to DMARDs. BMC Musculoskeletal Disord 2013;14:286.

Van Dijk L, Heerdink ER, Somai D, Van Dulmen S, Sluijs EM, de Ridder DT, et al. Patient risk profiles and practice variation in nonadherence to antidepressants, antihypertensives and oral hypoglycemics. BMC Health Serv Res 2007;7:51.

Horne R, Hankins M, Jenkins R. The satisfaction with information about medicines scale (SIMS): a new measurement tool for audit and research. Qual Health Care 2001;10:135-40.

Laivoranta-Nyman S, Luukkainen R, Hakala M, Hannonen P, Möttönen T, Yli-Kerttula U, et al. Differences between female and male patients with familial rheumatoid arthritis. Ann Rheum Dis 2001;60:413-5.

Treharne GJ, Lyons AC, Kitas GD. Medication adherence in rheumatoid arthritis: effects of psychosocial factors. Psychol Health Med 2004;9:337–49.

De Thurah A, Norgaard M, Harder I, Stengaard-Pedersen K. Compliance with methotrexate treatment in patients with rheumatoid arthritis: influence of patients' beliefs about the medicine. A prospective cohort study. Rheumatol Int 2010;30: 1441-8.

Neame R, Hammond A. Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology 2005;44:762-7.

Van den Bemt BJ, den Broeder AA, van den Hoogen FH, Benraad B, Hekster YA, van Riel PL, et al. Making the rheumatologist aware of patients' non-adherence does not improve medication adherence in patients with rheumatoid arthritis. Scand J Rheumatol 2011;40:192-6.

Kooy MJ, Van Geffen EC, Heerdink ER, Van Dijk L, Bouvy ML. Effects of a TELephone counseling intervention by the pharmacist (TelCIP) on medication adherence, patient beliefs and satisfaction with information for patients starting treatment: study protocol for a cluster randomized controlled trial. BMC Health Serv Res 2014;14:219.

Hill J, Bird H, Thorpe R. Effects of rheumatoid arthritis on sexual activity and relationships. Rheumatology 2003;42:280-6.

Sulaiman W, Toib A, Chandrashekhar G, Arshad A. The trends of DMARDS prescribed in rheumatoid arthritis patients in Malaysia. Oman Med J 2009;24:260.

Chakravarty K, McDonald H, Pullar T, Taggart A, Chalmers R, Oliver S, et al. BSR/BHPR guideline for disease-modifying antirheumatic drug (DMARD) therapy in consultation with the British association of dermatologists. Rheumatology 2008;47:924-5.

Published

01-07-2016

How to Cite

Wee, A. S., M. S. B. Mohamed Said, and A. B. Md. “MEDICATION ADHERENCE STATUS AMONG RHEUMATOID ARTHRITIS PATIENTS”. International Journal of Pharmacy and Pharmaceutical Sciences, vol. 8, no. 7, July 2016, pp. 317-21, https://journals.innovareacademics.in/index.php/ijpps/article/view/11977.

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Original Article(s)