Low rate of treatment adherence in patients with RA

Nonadherence to the treatment regimen is a major problem that affects about one-third of patients with rheumatoid arthritis (RA) who use disease-modifying antirheumatic drugs (DMARDs). The problem is unrelated to demographic and clinical characteristics, satisfaction about information, concerns about medication, and coping styles.

van den Bemt and colleagues used 3 self-report measures to examine adherence rates and nonadherence risk factors in 228 persons with RA who were taking a DMARD. They assessed patients’ beliefs about medicines, satisfaction about medicine information, and coping styles.

According to the measures, 33% to 40% of patients did not consistently take their medications as prescribed. No factors predicted nonadherence reliably, although patients with a new diagnosis and those who believed in the medication’s necessity were more likely to stay with the regimen. The adherent group reported fewer perceived adverse effects, although these concerns did not strongly influence adherence. Patients considered cost when balancing their beliefs about medication necessity against adverse effect concerns. All patients were more satisfied with information they received about medication effects and use than with information about possible problems.

The authors noted that effective interventions are needed to improve adherence in patients with RA for whom DMARDs are prescribed.