Compliance of disease-modifying anti-rheumatic drugs in rheumatoid arthritis patients: a longitudinal study.

Abstract

INTRODUCTION: Compliance of disease-modifying anti-rheumatic drugs (DMARDs) could affect the effectiveness of DMARDs for the treatment of rheumatoid arthritis in real-life clinical setting. Factors affecting compliance vary in different population and health care systems. This study aimed to identify the characteristics of patients with and the factors contributing to lower degree of compliance to DMARDs. METHODS: This study was conducted in Queen Mary Hospital. For inclusion, patients must be diagnosed with rheumatoid arthritis and treated with at least one DMARD(s). Levels of compliance and beliefs about medications were assessed using 19-item Compliance Questionnaire Rheumatology and the Beliefs about Medicine Questionnaire (BMQ) respectively. Demographic variables, disease activities, and health states were collected during patient visits. Results were analysed by using SPSS v22.0. RESULTS: A total of 385 patients were recruited into this study. Female sex and young age (56.7 ± 0.66 vs 60.5 ± 1.90; P=0.038) were associated with low levels of compliance. Patients with low levels of compliance had poorer patients’ global health (36.0 ± 1.57 vs 25.8 ± 3.97; P=0.017), lower BMQ necessity score (17.6 ± 0.17 vs 21.5 ± 0.43; P < 0.001). There was no significant difference in terms of education levels, disease duration and activities, and number of DMARDs used as stratified by the level of compliance. CONCLUSION: Low level of compliance is characterised with female sex, young age, poorer patients’ global health, lower level of necessity, and higher level of concerns about DMARDs.