Psychological, communication, and logistical factors: How do these influence treatment adherence?

By Samar Mahmoud, PhD
Published February 20, 2022

Key Takeaways

  • This prospective cohort study found that psychological, communication, and logistical factors play a bigger role in treatment adherence in patients with rheumatoid arthritis (RA) than sociodemographic or clinical factors. 

  • This work highlights the potential of patient-physician interactions to influence adherence rates.

RA is a chronic autoimmune disease characterized by systemic inflammation. While disease-modifying anti-rheumatic drugs (DMARDs) are recommended once an RA diagnosis is confirmed, treatment adherence in RA patients is often suboptimal.

Why This Study Matters 

Non-adherence undermines treatment efficacy and increases healthcare costs. Understanding the underlying factors that influence non-adherence is critical to designing and implementing intervention strategies. This study sought to estimate the incidence of treatment adherence in RA patients and to identify any underlying drivers of non-adherence.

Study design

This study included 180 patients with RA selected by systematic stratified sampling (33% were on a first-line DMARD, 33% received a second-line DMARD, and 33% received a biologic).

The primary outcome of the study was treatment adherence which was defined by a score greater than 80% in both the Compliance Questionnaire in Rheumatology and the Reported Adherence to Medication scale.

Investigators included the following predictive factors: sociodemographic, psychological, clinical, drug-related, patient–doctor relationship related, and logistic. Investigators examined the effect of the predictive factors on 6-month adherence using multilevel logistic models, adjusted for baseline covariates.

Results and conclusions

The study consisted of 77% female participants, with an average age of 60.8 years. The prevalence of adherence was 59.1%, with patients on biologics showing the highest rate of adherence and a higher perceived medication need than the other groups.

Investigators found that the factors underlying adherence were the type of treatment prescribed, agreement on treatment, if the patient received information on treatment adaptation, and the physician perception of patient trust. 

Related research

Consider these findings from similar research studies:

  • High self-efficacy is critical in guiding a patient to manage and adjust RA medications (Source). 

  • The most important factors for maintaining DMARDs adherence are reducing symptoms, maintaining independence, and shared decision making (Source).

Original Source 

Balsa A, Yébenes MJG de, Carmona L. Multilevel factors predict medication adherence in rheumatoid arthritis: a 6-month cohort study. Annals of the Rheumatic Diseases. 2022;81(3):327-334.

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