The Duality of Economic Issues With Medication Non-adherence in Patients With Inflammatory Arthritis
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Purpose of Review
In this review, we synthesize current data on non-adherence across inflammatory arthritides and explore (1) the effects of economic factors on non-adherence and (2) the impacts of non-adherence on economic outcomes.
Recent evidence demonstrates medication non-adherence rates as high as 74% in ankylosing spondylitis (AS), 90% in gout, 50% in psoriatic arthritis (PsA), 75% in systemic lupus erythematosus (SLE), and 82% in rheumatoid arthritis (RA).
The effects of socioeconomic factors have been studied most in RA and SLE but with inconsistent findings. Nonetheless, the evidence points to having prescription coverage and costs of treatment as important factors in RA and education as an important factor in SLE. Limited data in AS and gout, and no studies of the effects of socioeconomic factors in PsA, show knowledge gaps for future research. Finally, there is a dearth of data with respect to the impacts of non-adherence on economic outcomes.
KeywordsInflammatory arthritis Adherence Patient compliance Health economics Costs
Compliance with Ethical Standards
Funding and Grant Support
Dr. De Vera is the Canada Research Chair in Medication Adherence, Utilization, and Outcomes and is a recipient of The Arthritis Society Network Scholar Award and Michael Smith Foundation for Health Research Scholar Award.
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Papers of particular interest, published recently, have been highlighted as: • Of importance
- 2.• Mehat P, Atiquzzaman M, Esdaile JM, et al. Medication non-adherence in systemic lupus erythematosus: a systematic review. Arthritis Care & Research. 2017 (published online 13 January 2017). This systematic review synthesized the data on the burden and determinants of medication non-adherence among SLE patients.Google Scholar
- 7.• Marengo MF, Suarez-Almazor ME. Improving treatment adherence in patients with rheumatoid arthritis: what are the options? Int J Clin Rheumatol. 2015;10(5):345–56. This review summarized the recent literature on determinants of adherence, and related interventions, that can improve therapeutic adherence in patients with RA.CrossRefGoogle Scholar
- 12.Sabate E. Adherence to long-term therapies: evidence for action. Geneva, Switzerland: World Health Organization; 2003.Google Scholar
- 14.Iuga AO, McGuire MJ. Adherence and health care costs. Risk Manag & Healthcare Policy. 2014;7:35–44.Google Scholar
- 19.Urquhart JV, B. New findings about ptaient adherence to prescribed drug dosing regimens: an introduction to pharmionics. Eur J Hospital Phar Sci. 2005;11(5):103–6.Google Scholar
- 29.Ward MM, Deodhar A, Akl EA, et al. American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network 2015 recommendations for the treatment of ankylosing spondylitis and nonradiographic axial spondyloarthritis. Arthritis Rheum. 2015;68(2):282–98.CrossRefGoogle Scholar
- 32.Heiberg MS, Koldingsnes W, Mikkelsen K, et al. The comparative one-year performance of anti-tumor necrosis factor α drugs in patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis: results from a longitudinal, observational, multicenter study. Arthritis Care Res. 2008;59(2):234–40.CrossRefGoogle Scholar
- 41.Zhang W, Doherty M, Bardin T, et al. EULAR evidence based recommendations for gout. Part II: management. Report of a task force of the EULAR Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2006;65(10):1312–24.CrossRefPubMedPubMedCentralGoogle Scholar
- 50.Firestein GS, Budd RC, Gabriel SE, et al. Kelley’s textbook of rheumatology: expert consult premium edition. 9th ed. Philadelphia: Saunders; 2012. 2292 p.Google Scholar
- 51.Cojocaru M, Cojocaru IM, Silosi I, et al. Manifestations of systemic lupus erythematosus. Maedica (Buchar). 2011;6(4):330–6.Google Scholar
- 52.Klippel JH, Stone JH, White PH. Primer on the rheumatic diseases. Springer Science & Business Media; 2008. 703 p.Google Scholar
- 54.Bertsias GK, Tektonidou M, Amoura Z, et al. Joint European League Against Rheumatism and European Renal Association–European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of adult and paediatric lupus nephritis. Ann Rheum Dis. 2012;71(11):1771–82.CrossRefPubMedPubMedCentralGoogle Scholar
- 55.Aviña-Zubieta JA, Esdaile JM. Chapter 49. Antimalarial medications. In: Wallace D, Hahn BH, editors. Dubois’ lupus erythematosus and related syndromes. 8th ed. Philadelphia: Elsevier Saunders; 2012. p. 601–8.Google Scholar
- 60.Abdul-Sattar AB, Abou El Magd SA. Determinants of medication non-adherence in Egyptian patients with systemic lupus erythematosus: Sharkia Governorate. Rheumatol Int. 2015;35(6):1045–51.Google Scholar
- 70.Quinn MA, Conaghan PG, O’Connor PJ, et al. Very early treatment with infliximab in addition to methotrexate in early, poor-prognosis rheumatoid arthritis reduces magnetic resonance imaging evidence of synovitis and damage, with sustained benefit after infliximab withdrawal: results from a twelve-month randomized, double-blind, placebo-controlled trial. Arthritis Rheum. 2005;52(1):27–35.CrossRefPubMedGoogle Scholar