The adherence questionnaires in chronic inflammatory rheumatic diseases and their psychometric properties: A systematic literature review

Rakotozafiarison, Antsa; Puyraimond-Zemmour, Déborah; Romand, Xavier; Lavielle, Matthieu; Moltó, Anna; Flipo, René‐Marc; Richez, Christophe; Saraux, Alain; Dougados, Maxime; Gossec, Laure

doi:10.1016/j.jbspin.2021.105160

Cited by 1 publication

(1 citation statement)

References 9 publications

(8 reference statements)

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“…However, a recent systematic review of the literature concluded that, to date, there is no simple, reliable and valid questionnaire for assessing medication adherence. 33 Some argue that Medication Event Monitoring Systems are gold standards, but because of the bias due to the patient knowing he is monitored, the possible tampering of data, and its cost, it cannot be used in clinical practice. 20 The limitations of the study include the monocentric recruitment in a tertiary centre, where adherence is reputed to be higher due to frequent intervention in therapeutic education.…”

Section: Discussionmentioning

confidence: 99%

Urinary methotrexate dosage in rheumatoid arthritis, in patients treated for at least 6 months: a potential marker of adherence

Théate,

Geoffroy,

Kanagaratnam

et al. 2024

RMD Open

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ObjectivesNon-adherence to rheumatoid arthritis (RA) treatments must be identified. A methotrexate (MTX) urinary dosage (METU) was recently developed. The aim of our study was to assess adherence to MTX in RA using METU in real-life conditions and to compare it with indirect adherence measurement technics.MethodsWe performed a cross-sectional study at Reims University Hospital. We included over 18-year-old patients with RA treated by MTX for more than 6 months. Patients were invited to complete demographic, clinical and psychological questionnaires and adherence measurement technics (Compliance Questionnaire of Rheumatology (CQR) and Medication Possession Ratio (MPR)). A urinary sample was collected to measure MTX and information about tolerance was evaluated through Methotrexate Intolerance Severity Score.Results84 patients were included, 26 using oral MTX, 58 subcutaneous (SC) MTX. Among them, 73% were female, mean age was 61.5 years, MTX mean dose was 15 mg/week and 61.9% were treated by biological DMARDs (Disease Modifying Antirheumatic Drugs). 77 patients (91.7%) were adherent to treatment according to METU, whereas MPR and CQR reported less adherence (69.5% and 61.9%, respectively). MPR and METU were not significantly different in SC MTX users (p=0.059). Non-adherent patients had a higher number of tender joints and C reactive protein value (p<0.05).ConclusionThis is the first largest study evaluating MTX adherence in patients with RA using a urinary dosage. We identified that indirect adherence measurements did not reflect real-life adherence. It would be appreciable to realise METU, in a new study, in patients with RA with unexplained response to treatment, to consider it before escalating therapeutic strategy.

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Section: Discussionmentioning

confidence: 99%