Rate and causes of noncompliance with disease-modifying antirheumatic drug regimens in patients with rheumatoid arthriti
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ORIGINAL ARTICLE
Rate and causes of noncompliance with disease-modifying antirheumatic drug regimens in patients with rheumatoid arthritis Wanruchada Katchamart 1 Ananya Srisomnuek 4
&
Pongthorn Narongroeknawin 2 & Ngamsiree Sukprasert 3 & Wanwisa Chanapai 4 &
Received: 4 August 2020 / Revised: 1 September 2020 / Accepted: 15 September 2020 # International League of Associations for Rheumatology (ILAR) 2020
Abstract Introduction/objectives To determine the prevalence and factors associated with medication noncompliance by Thai patients with rheumatoid arthritis (RA). Methods This prospective cohort study enrolled 443 adult RA patients (≥ 18 years) who were followed up at the outpatient rheumatology clinics of Siriraj Hospital and Phramongkutklao Hospital between May 2018 and December 2019. Medication noncompliance was assessed using the Compliance Questionnaire for Rheumatology–19 (CQR-19). A score of 0 indicated complete noncompliance, whereas a score of 100 indicated a perfect compliance. An unsatisfactory compliance was arbitrarily defined as a taking compliance of ≤ 80%. Results The prevalence of medication noncompliance was 22.1%. The most common cause was forgetting to take medications due to a busy work schedule. In a univariate analysis, the factors that were significantly related to medication noncompliance were age, income, number of comorbidities, functional status as measured by the Health Assessment Questionnaire (HAQ), number of prescribed pills per day, and number of types of prescribed medications per day. In a subsequent backward stepwise multiple logistic regression analysis, only 2 factors were found to be negatively associated with medication noncompliance: age (risk ratio, 0.98; 95% CI, 0.96–0.99; p, 0.048) and HAQ (risk ratio, 0.62; 95% CI, 0.39–0.98; p, 0.041). Conclusions Medication noncompliance is common in patients with RA. As this may lead to unfavorable outcomes, patient education related to drug compliance should be addressed and emphasized in daily practice. Key Points • Medication noncompliance is common in patients with RA. • Forgetting to take pills was the most frequent explanation offered for noncompliance. • All patients should be strongly encouraged to comply with the recommended drug regimens.
Keywords Compliance-Questionnaire-Rheumatology . Medication compliance . Rheumatoid arthritis
* Wanruchada Katchamart [email protected] 1
Division of Rheumatology, Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkok Noi, Bangkok 10700, Thailand
2
Division of Rheumatology, Department of Medicine, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
3
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
4
Division of Clinical Trials, Research Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Introduction Rheumatoid arthritis (RA) is a chronic, idiopathic, inflammatory disease of the synovial joints that can also
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