Abstract

EVALUATING ADHERENCE TO TREATMENT IN PATIENTS OF RHEUMATOID ARTHRITIS AND FACTORS AFFECTING ADHERENCE

Rakshit Sehgal*, M.C. Gupta and Harpreet Singh

ABSTRACT

Introduction: Traditional disease modifying anti-rheumatic drugs (DMARDs) are considered the foundation of Rheumatoid Arthritis (RA) treatment. Adherence to treatment in chronic diseases like RA is vital as it influences the long term therapeutic outcomes. Aim & Objectives: To evaluate adherence to treatment in patients of rheumatoid arthritis on DMARDs and further establish the co-relation of adherence with various demographic, educational and drug related variables. Material and Methods: A randomised cross-sectional questionnaire based study was carried out in 85 patients of Rheumatoid Arthritis receiving DMARDs. Patient demographic, educational and drug related variables were recorded. A voluntary written informed consent was taken. Adherence was assessed using Morisky Medication Adherence Scale (MMAS-8). Results: Overall, 36.5% of patients were high on adherence level and 63.5% were medium to low in adherence. Clinically non-adherence was prevalent in both age groups with statistically significant non-adherence in the age group of 41-80 years (p-value: 0.005). As compared to males, females were more non-adherent. Significant non-adherence (p value: 0.027) was also established in patients with only up to primary level of education. Non-adherence was also observed to be more in patients having adverse drug reactions (ADRs) and co-morbidities. Conclusion: Adherence to treatment was generally found to be on the lower side in patients of RA on DMARDs. Presence of ADRs, co-morbidities and a lower educational status in patients affected adherence poorly. Implementing strategies to promote compliance to treatment is therefore needed.

Keywords: Adherence, Rheumatoid Arthritis, Disease Modifying Anti-rheumatic Drugs (DMARDs).