RT Journal Article
SR Electronic
T1 Facilitators and Barriers to Adherence in the Initiation Phase of Disease-modifying Antirheumatic Drug (DMARD) Use in Patients with Arthritis Who Recently Started Their First DMARD Treatment
JF The Journal of Rheumatology
JO J Rheumatol
FD The Journal of Rheumatology
SP jrheum.140693
DO 10.3899/jrheum.140693
A1 Annelieke Pasma
A1 Adriaan van’t  Spijker
A1 Jolanda J.  Luime
A1 Margot J.M.  Walter
A1 Jan J.V.  Busschbach
A1 Johanna M.W.  Hazes
YR 2014
UL http://www.jrheum.org/content/early/2014/12/10/jrheum.140693.abstract
AB Objective To explore themes associated with adherence in the initiation phase for first-time use of disease-modifying antirheumatic drugs (DMARD) in patients with inflammatory arthritis using focus groups and individual interviews. Methods Thirty-three patients were interviewed in focus groups and individual interviews. Interviews were transcribed verbatim and imported into ATLAS.ti software (Scientific Software Development GmbH). Responses that included reasons for adherence or nonadherence in the initiation phase were extracted and coded by 2 coders separately. The 2 coders conferred until consensus on the codes was achieved. Codes were classified into overarching themes. Results Five themes emerged: (1) symptom severity, (2) experiences with medication, (3) perceptions about medication and the illness, (4) information about medication, and (5) communication style and trust in the rheumatologist. Conclusion Perceptions about medication and the communication style with, and trust in, the rheumatologist were mentioned the most in relation to starting DMARD. The rheumatologist plays a crucial role in influencing adherence behavior by addressing perceptions about medication, providing information, and establishing trust in the treatment plan.