J Rheum Dis.  2018 Jan;25(1):47-57. 10.4078/jrd.2018.25.1.47.

Prevalence and Associated Factors for Non-adherence in Patients with Rheumatoid Arthritis

• Kim D
• Choi JY
• Cho SK
• Choi CB
• Bang SY
• Cha HS
• Choe JY
• Chung WT
• Hong SJ
• Kim TH
• Kim TJ
• Koh E
• Lee HS
• Lee J
• Lee SS
• Lee SW
• Park SH
• Shim SC
• Yoo DH
• Yoon BY
• Bae SC
• Sung YK

• KMID: 2405020
• DOI: http://doi.org/10.4078/jrd.2018.25.1.47

Abstract

OBJECTIVE
To estimate the prevalence of non-adherence to rheumatoid arthritis (RA) medication and identify the associated factors for non-adherence in RA patients.
METHODS
Among the KORean Observational study Network for Arthritis 3,523 patients who completed a questionnaire about the adherence to RA medication were analyzed. The patients were divided into two groups: 1) adherent group, patients who skipped medication ≤5 days within the past 2 months; and 2) non-adherent group, patients who skipped ≥6 days of medication. The baseline characteristics were compared, and multivariable regression analysis was performed to identify the associated factors for non-adherence.
RESULTS
The non-adherent group had 339 patients (9.6%). The common causes of non-adherence were forgetfulness (45.8%), absence of RA symptoms (24.7%), and discomfort with RA medication (13.1%). Younger age (odds ratio [OR] 1.02, p < 0.01) and higher income (OR 1.70, p < 0.01) were associated with an increased risk of non-adherence. Whereas higher functional disability (OR 0.68, p < 0.01) and oral corticosteroid use (OR 0.73, p=0.02) were associated with a decreased risk of non-adherence. The associated factors differed according to cause of non-adherence. Having adverse events (OR 2.65, p=0.02) was associated with the risk of non-adherence due to discomfort with RA medication while a higher level of education (OR 2.37, p=0.03) was associated with the risk of non-adherence due to an absence of RA symptoms.
CONCLUSION
The 9.6% of Korean RA patients were non-adherent to RA medication. The associated factors differed according to the cause of non-adherence. Therefore, an individualized approach will be needed to improve the adherence to RA medication.

Keyword

Medication adherence; Arthritis; rheumatoid; Prevalence

MeSH Terms

Arthritis
Arthritis, Rheumatoid*
Education
Humans
Medication Adherence
Observational Study
Prevalence*

Figure

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  Figure 1. Patient selection flow chart. KORONA: KORean Observational study Network for Arthritis.

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  Figure 2. Causes of non-adherence in rheumatoid arthritis (RA) patients.

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