Skip to main content

Advertisement

SpringerLink
Log in

Compliance with treatment of rheumatoid arthritis

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript

Abstract

Rheumatoid arthritis (RA) is a chronic, progressive, debilitating disease that demands continuous therapy with multiple medications. Noncompliance with disease-modifying drugs may cause disease flares, preventable functional impairment, unnecessary treatment changes, and loss of health care resources. The aim of the current study was to explore self-reported compliance with treatment and the factors contributing to this compliance using a representative sample of an RA patient population in Estonia. Two thousand patients diagnosed with RA were randomly selected from the Estonian Health Insurance Fund database. The eligible response rate of the study was 60%. Using prestructured questionnaires, the following information about the disease and treatment was evaluated: self-reported compliance with treatment, reasons for noncompliance, disease history, sociodemographic variables, health care utilization, and satisfaction with health care providers. The self-reported compliance rate was 80.3%, reflecting the percentage of patients who reported that they always took their medications exactly as described. The most often reported reasons for noncompliance were side effects and fear of side effects. Compliance was found to be the lowest in a group of younger and active patients with higher income. Higher frequency of visits to the rheumatologist, satisfaction with health care providers, and sufficient information about RA treatment correlated with better compliance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353:487–497

    Article  PubMed  CAS  Google Scholar 

  2. de Klerk E, van der Heijde D et al (2003) Patient compliance in rheumatoid arthritis, polymyalgia rheumatica, and gout. J Rheumatol 30:44–54

    PubMed  Google Scholar 

  3. Pullar T, Peaker S et al (1988) The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy. Br J Rheumatol 27:381–384

    Article  PubMed  CAS  Google Scholar 

  4. Tanaka E, Mannalithara A (2008) Efficient management of rheumatoid arthritis significantly reduces long-term functional disability. Ann Rheum Dis 67:1153–1158

    Article  PubMed  CAS  Google Scholar 

  5. Contreras-Yáñez I, Ponce De León S (2010) Inadequate therapy behavior is associated to disease flares in patients with rheumatoid arthritis who have achieved remission with disease-modifying antirheumatic drugs. Am J Med Sci 340:282–290

    Article  PubMed  Google Scholar 

  6. Pascual-Ramos V, Contreras-Yáñez I et al (2009) Medication persistence over 2 years of follow-up in a cohort of early rheumatoid arthritis patients: associated factors and relationship with disease activity and with disability. Arthritis Res Ther 11:R26

    Article  PubMed  Google Scholar 

  7. WHO (2003) Adherence to long-term therapies—evidence for action. http://www.who.int/chp/knowledge/publications/adherence_report/en/

  8. Horne R, Weinman J, et al (2005) Concordance, adherence and compliance in medicine taking. Report for the National Co-ordinating Centre for NHS Service Delivery and Organisation. http://www.medslearning.leeds.ac.uk/pages/documents/useful_docs/76-final-report%5B1%5D.pdf

  9. Rogers P (1995) Prescription medication compliance: a review of the baseline of knowledge. A report of the national council on patient information and patient education. J Pharmacoepidemiol Drug Saf 2:3–36

    Google Scholar 

  10. Harrold L, Andrade S (2009) Medication adherence of patients with selected rheumatic conditions: a systematic review of the literature. Sem in Arthritis and Rheum 38:396–402

    Article  Google Scholar 

  11. Tuncay R, Eksioglu E (2007) Factors affecting drug treatment compliance in patients with rheumatoid arthritis. Rheumatol Int 27:743–746

    Article  PubMed  Google Scholar 

  12. Taal E, Rasker JJ (1993) Health status, adherence with health recommendations, self-efficacy and social support in patients with rheumatoid arthritis. Patient Educ Couns 20:63–76

    Article  PubMed  CAS  Google Scholar 

  13. de Thurah A, Nørgaard M, Harder I, Stengaard-Pedersen K (2010) Compliance with methotrexate treatment in patients with rheumatoid arthritis: influence of patients’ beliefs about the medicine. A prospective cohort study. Rheumatol Int 30:1441–1448

    Article  PubMed  CAS  Google Scholar 

  14. Elliott RA (2008) Poor adherence to medication in adults with rheumatoid arthritis: reasons and solutions. Dis Manage Health Outcomes 16:13–29

    Article  Google Scholar 

  15. Li P, Blum M (2010) Adherence, discontinuation, and switching of biologic therapies in medicaid enrollees with rheumatoid arthritis. Value Health 13:805–812

    Article  PubMed  CAS  Google Scholar 

  16. Hetland M, Christensen J et al (2010) Direct comparison of treatment responses, remission rates, and drug adherence in patients with rheumatoid arthritis treated with adalimumab, etanercept, or infliximab: results from eight years of surveillance of clinical practice in the nationwide Danish DANBIO registry. Arthritis Rheum 62:22–32

    Article  PubMed  CAS  Google Scholar 

  17. Koncz T, Pentek M et al (2010) Adherence to biologic DMARD therapies in rheumatoid arthritis. Expert Opin Biol Ther 10:1367–1378

    Article  PubMed  CAS  Google Scholar 

  18. De Achaval S, Suarez-Almazor M et al (2010) Treatment adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis and systemic lupus erythematosus. Int J Clin Rheumatol 5:313–326

    Article  Google Scholar 

  19. DiMatteo R (2004) Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 42:200–209

    Article  PubMed  Google Scholar 

  20. Koppel K, Kahur K (2008) Estonia. Health system review. Health Syst Trans 10:1

    Google Scholar 

  21. Mosley-Williams A, Lumley M et al (2002) Barriers to treatment adherence among African American and white women with systemic lupus erythematosus. Arthritis Care Res 47:630–638

    Article  Google Scholar 

  22. Garber MC, Nau D (2004) The concordance of self-report with other measures of medication adherence. A summary of the literature. Med Care 42:649–652

    Article  PubMed  Google Scholar 

  23. De Klerk E, Van der Heijde D et al (2003) The compliance- questionnaire- rheumatology compared with electronic medication event monitoring: a validation study. J Rheumatol 30:2469–2475

    PubMed  Google Scholar 

  24. Park DC, Hertzog C et al (1999) Medication adherence in rheumatoid arthritis patients: older is wiser. J Am Geriatr Soc 47:172–183

    PubMed  CAS  Google Scholar 

  25. Van den Bemt BJ, van den Hoogen FH (2009) Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease modifying antirheumatic drugs. J Rheumatol 36(10):2164–2170

    Article  PubMed  Google Scholar 

  26. Viller F, Guillemin F et al (1999) Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study. J Rheumatol 26:2114–2122

    PubMed  CAS  Google Scholar 

  27. Brus H, van de Laar M (1997) Compliance in rheumatoid arthritis and the role of formal patient education. Semin Arthritis Rheum 26(4):702–710

    Article  PubMed  CAS  Google Scholar 

  28. Neto L (2009) Evaluation of the efficacy of an educational program for rheumatoid arthritis patients. Clin Exp Rheumatol 27:28–34

    Google Scholar 

  29. Smolen JS, Aletaha D, Johannes W, Bijlsma JW et al (2010) Treating rheumatoid arthritis to target: recommendations of an international task force. Ann Rheum Dis 69:631–637

    Article  PubMed  Google Scholar 

  30. Adams RJ, Smith BJ, Ruffin RE (2001) Patient preferences for autonomy in decision making in asthma management. Thorax 56:126–132

    Article  PubMed  CAS  Google Scholar 

  31. Lantos J, Matlock AM, Wendler D (2011) Clinician integrity and limits to patient autonomy. JAMA 305:495–499

    Article  PubMed  CAS  Google Scholar 

Download references

Acknowledgments

This study was funded by the Estonian Science Foundation (Grant No. 6461), the Ministry of Education and Research of Estonia (targeted financing SF0180081s07), and the Estonian Health Insurance Fund.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, University of Tartu and Tartu University Hospital, Tartu, Estonia

    Raili Müller, Riina Kallikorm, Kaja Põlluste & Margus Lember

Authors
  1. Raili Müller
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Riina Kallikorm
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kaja Põlluste
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Margus Lember
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Raili Müller.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Müller, R., Kallikorm, R., Põlluste, K. et al. Compliance with treatment of rheumatoid arthritis. Rheumatol Int 32, 3131–3135 (2012). https://doi.org/10.1007/s00296-011-2162-x

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00296-011-2162-x

Keywords

Search

Navigation