Adherence to Treatment in Patients with Rheumatoid Arthritis from Spain

Abstract

Objective: To evaluate adherence to treatment in a cohort of patients with rheumatoid arthritis in Spain and to identify potential predictors of adherence. Methods: An observational, cross-sectional, multicenter study in outpatient clinics of Rheumatology Departments from 41 centers was conducted. A validated Spanish version of the compliance questionnaire in Rheumatology was used to measure adherence in a cohort of patients with rheumatoid arthritis, representative of the Spanish population. Univariate and multivariate analyses were performed to detect predictors of adherence. Results: A total of 859 patients were recruited. An adherence rate of 79% was established. No differences were detected in adherence in patients receiving biologic disease-modifying antirheumatic drugs compared to conventional disease-modifying antirheumatic drugs, in patients receiving intravenous therapies compared to other routes of administration and in patients treated in specific day hospitals compared to polyvalent day hospitals. The number of drugs and cohabitation were independent predictors of adherence. Conclusion: An inexpensive and useful method was used to measure adherence in Spanish population. The adherence rate in rheumatoid arthritis is still suboptimal. Simpler, more convenient dosing regimens may improve compliance. Increased knowledge of compliance in patients with rheumatoid arthritis and the identification of possible predictors of adherence will allow to develop effective intervention strategies.

An Overview on Causes of Nonadherence in the Treatment of Rheumatoid Arthritis: Its Effect on Mortality and Ways to Improve Adherence

“…Bak-Sosnowska et al concluded that elderly patients appeared to use pharmacotherapy more systematically, which may result from a greater level of adaptation to the disease and its acceptance compared to younger patients, but also from objective factors, such as regular daily routine or more free time [ 2 ]. On the other hand, through ANOVA analysis, age was not identified as a predictor of adherence in a cross-sectional, multi-center study performed in Spain which is consistent with results obtained by Alrubaye et al in Iraq [ 20 , 21 ].…”

“…The complexity of a patient’s drug regimen, which includes but is not limited to multiple medications, numerous doses, and specific time requirements, is related to poorer adherence to RA [ 19 , 20 ]. A review of literature studies was analyzed, which confirmed that the number of doses per day, as well as the complexity of the drug schedule, was inversely proportional to adherence [ 6 ].…”

“…Another contributory factor to medication nonadherence in RA patients is cohabitation status. Pombo-Suarez et al found that in a multivariate analysis adjusted for age and sex, cohabitation was independently associated with adherence in the Spanish population [ 20 ]. Social and family support seem to be important factors contributing to proper adherence and living alone has been previously associated with poorer adherence.…”

Perspectives on Subcutaneous Infliximab for Rheumatic Diseases and Inflammatory Bowel Disease: Before, During, and After the COVID-19 Era

“…Combined with the IV formulation, CT-P13 SC may afford patients more control over their treatment [ 125 ], with increased flexibility and convenience [ 13 ]. In turn, this could improve adherence: a Spanish observational study in RA concluded that compliance could be increased with less complex regimens [ 126 ]. HCPs must ensure that patients receive sufficient information and guidance to safely continue to self-administer SC therapeutics, including CT-P13 SC, over the long-term.…”

Evaluation of Newly Designed Blister Packs for Easier Handling to Prevent Pill Dropping

“…7 , 8 These situations are closely related in that healthy older adults and patients with RA both make substantial efforts in terms of drug-taking in their daily lives, including the use of personal devices to improve the ease of opening ( Table 5 ). 9 , 10 Patients with RA tend to have weak pinch power, so these issues could pose more serious problems. The fact that a high percentage of patients use their own devices also suggests the need for better drug-taking support.…”