The Influence of Socio-Demographic Factors, Lifestyle and Psychiatric Indicators on Adherence to Treatment of Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Abstract

Background and Objectives: Rheumatoid arthritis (RA) is a severe autoimmune disease characterized by chronic inflammation of the joints accompanied by the progressive deformation and destruction of cartilage and joint bones. This study aims to gain insight into the outcomes related to adherence in patients with rheumatoid arthritis. Predicting the medication adherence in RA patients is a key point to improve the treatment outcome. Materials and Methods: A number of 119 Romanian patients with RA were included and divided into two groups: first group included 79 patients treated with conventional therapy and second group included 40 patients treated with biologic therapy. A CQR-9 (compliance questionnaire rheumatology with nine items) and PDSQ (psychiatric diagnostic screening questionnaire) were performed to assess correlations between medication adherence, patient sociodemographic variables, 11 psychiatric scales (major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, generalized anxiety disorder, somatization disorder, hypochondriasis) and lifestyle (bulimia, alcohol intake). Results: Whilst modelling factors associated with adherence, it was found that women and patients with higher education are more adherent. From the psychiatric indicators, only major depressive disorder and post-traumatic stress disorder were found to be positively correlated with therapeutic adherence. None of the assessed lifestyle factors influenced the adherence of RA patients. Conclusion: The knowledge of factors that impact on treatment adherence can be useful for clinicians to guide patient-centred care.

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“…Patients with higher education levels had a higher proportion of medication adherence (p = 0.013), similar to the study by Turcu-Stiolica et al in Rome, from 2017 to 2019 [22]. Many of the results of previous studies demonstrated that people with poor health knowledge tended not to adhere to medication guidelines [23,24].…”

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“…In addition, there have been numerous reports of an association between stress and lifestyle [ 5 , 6 , 7 ], and in countries where there is a need to focus on measures for lifestyle-related diseases, it is important to clarify the stress factors that are part of the backdrop to disease.…”

Selected psychological factors and medication adherence in patients with rheumatoid arthritis

“…This result is difficult to compare with the results of studies conducted in other countries in the same group of patients, due to variability of measuring tools and different categorisation of the results regarding the studied variable (two, three or four categories). For instance, in a Brazilian study the level of medication adherence in RA patients was 16.4% [30], in a Dutch study the MA level was 60% [10], and in a Romanian study it was 60.34% for the conventional therapy, and 81.30% for the biological therapy [31].…”

“…The number of men and women participating in the study was not equal, but it reflects the dominance of women in the general population of patients with RA. Finally, it should be emphasised that, as demonstrated by other authors [31], medication adherence is a dynamic process, and can change in time, similarly to certain psychological characteristics that may evolve spontaneously, due to life experience, or be changed intentionally, as a result of new competences. Therefore, the results of the study do not necessarily reflect a permanent predisposi-tion for medication adherence in a patient with RA, but rather the present situation, a point in the patient's life.…”