Compliance with DMARD therapy in RA patients in a tertiary referral centre

Marwaha, Vishal; Reddy, KRK; Amarendra,; Aggarwal, Neeru P; Nagpal, Avish

doi:10.1016/j.injr.2014.10.031

Cited by 1 publication

(5 citation statements)

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“…For each study, data were extracted and quality was assessed. Results are summarized in Table 1 9,11,12,19,20,21,22,23,24,25,26,27 , Table 2, Table 3 [28][29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47]48,49,50,51,52,53,54,55,56 , and Table 4, as well as Supplementary Table 2 and Supplementary Table 3 (available online at jrheum.org). MTX adherence.…”

Section: Resultsmentioning

confidence: 99%

“…MTX adherence. Twelve studies were identified that evaluated MTX adherence in patients with RA (Table 1) 9,11,12,19,20,21,22,23,24,25,26,27 . Most patients were enrolled in rheumatology outpatient clinics and were receiving MTX for the first time (Supplementary Table 2, available online at jrheum.org).…”

Section: Resultsmentioning

confidence: 99%

“…Five studies included populations unlikely to be representative of the general population (enrollment in a social healthcare program for persons with low income and limited resources 21 , RA duration < 1 yr 9 , predominantly men 11 , sample from an outpatient clinic in India 24 , and economically disadvantaged 12 ). Accounting for loss of followup was insufficient in many studies.…”

Section: Resultsmentioning

confidence: 99%

“…The remaining studies used various methods of patient reporting to evaluate adherence 9,23,24 . In a 9-month prospective Danish study that evaluated beliefs about medication, patients who were first-time MTX users were identified through a prescription database and completed the Compliance Questionnaire Rheumatology (CQR) at baseline and 9 months 23 …”

Section: Rheumatologymentioning

confidence: 99%

“…Adherence, defined as percentage of doses taken correctly ≥ 80% of the time, was 78% for patients treated with monotherapy and 14-49% for patients treated with MTX in combination with other DMARD. A patient report was also used to evaluate MTX adherence in patients with RA at a rheumatology outpatient clinic in India 24 . Of the patients who returned for the 3-month visit (n = 50), 92% stated that they had taken MTX as prescribed.…”

Section: Rheumatologymentioning

confidence: 99%

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Adherence and Persistence with Methotrexate in Rheumatoid Arthritis: A Systematic Review

Curtis

Bykerk

Aassi³

et al. 2016

J Rheumatol

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Objective.Medication adherence in patients with rheumatoid arthritis (RA) is typically suboptimal. Nonadherence has been associated with symptom worsening and increased disability. We systematically reviewed published clinical studies to evaluate methotrexate (MTX) adherence and persistence, factors associated with MTX adherence and persistence, and the effect of MTX nonadherence on clinical outcomes in RA.Methods.MEDLINE and Embase were systematically searched (inception to February 2016) using relevant keywords. Observational or interventional clinical studies in patients with RA that specifically reported adherence to or persistence with MTX were included. Data were extracted using a predesigned, standardized template that included study design, patient demographics, and relevant outcomes. Main outcomes were MTX adherence and persistence rates in patients with RA treated with MTX and factors associated with MTX adherence and persistence.Results.Of 365 references screened, 31 articles met inclusion criteria and another 10 were identified from searching reference lists. Estimates of MTX adherence varied from study to study because of heterogeneity in patient populations, duration of followup, definitions of adherence, and methods of assessment. Rates of MTX persistence ranged from 50% to 94% at 1 year and 25% to 79% at 5 years. No clear trends were identified in factors that influence MTX adherence and persistence. Two studies suggested that MTX adherence was associated with superior clinical outcomes.Conclusion.MTX adherence and persistence are highly variable in patients with RA. Research is necessary to determine the effect of nonadherence on health outcomes and to identify independent predictors of nonadherence to inform evidence-based interventions.

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