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ReplyCorrespondence

Dr. Harrold, et al reply

LESLIE R. HARROLD, JERRY H. GURWITZ and BECKY A. BRIESACHER
The Journal of Rheumatology August 2013, 40 (8) 1462; DOI: https://doi.org/10.3899/jrheum.130473
LESLIE R. HARROLD
Meyers Primary Care Institute, and the University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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  • For correspondence: Leslie.Harrold@umassmed.edu
JERRY H. GURWITZ
Meyers Primary Care Institute, and the University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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BECKY A. BRIESACHER
Meyers Primary Care Institute, and the University of Massachusetts Medical School, Worcester, Massachusetts, USA.
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To the Editor:

We thank Drs. Ravindran and Jadhav for their interest1 in our article describing cost-related medication nonadherence in older patients with rheumatoid arthritis cared for in the United States2. We agree with their comments that adherence to medications is a complex behavior that is influenced by patient factors3,4. Those authors wondered whether patient education may have influenced the adherence rates we observed in our study rather than costs, similar to what they found in their prospective cohort study in which patients receiving education had higher adherence than the control group (98% vs 83%). This is certainly possible, although we have no data in our study for examining the role of patient education on medication adherence. Of note, the study populations were quite different between the 2 studies. Ours focused on a national sample of US older patients with a variety of drug payment coverage arrangements, and the majority of the patients were not working. In contrast, the sample in the study by Drs. Ravindran and Jadhav was younger, with most being homemakers or workers with self-funded healthcare, and living in India3.

REFERENCES

  1. 1.↵
    1. Ravindran V,
    2. Jadhav R
    . The effect of rheumatoid arthritis disease education on adherence to medications and followup in Kerala, India [letter]. J Rheumatol 2013;40:1460–2.
    OpenUrlFREE Full Text
  2. 2.↵
    1. Harrold LR,
    2. Briesacher BA,
    3. Peterson D,
    4. Beard A,
    5. Madden J,
    6. Zhang F,
    7. et al.
    Cost-related medication nonadherence in older patients with rheumatoid arthritis. J Rheumatol 2013;40:137–43.
    OpenUrlAbstract/FREE Full Text
  3. 3.↵
    1. Harrold LR,
    2. Andrade SE
    . Medication adherence of patients with selected rheumatic conditions: A systematic review of the literature. Semin Arthritis Rheum 2009;38:396–402.
    OpenUrlCrossRefPubMed
  4. 4.↵
    1. Osterberg L,
    2. Blaschke T
    . Adherence with medication. N Engl J Med 2005;353:487–97.
    OpenUrlCrossRefPubMed
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The Journal of Rheumatology
Vol. 40, Issue 8
1 Aug 2013
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Dr. Harrold, et al reply
LESLIE R. HARROLD, JERRY H. GURWITZ, BECKY A. BRIESACHER
The Journal of Rheumatology Aug 2013, 40 (8) 1462; DOI: 10.3899/jrheum.130473

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Dr. Harrold, et al reply
LESLIE R. HARROLD, JERRY H. GURWITZ, BECKY A. BRIESACHER
The Journal of Rheumatology Aug 2013, 40 (8) 1462; DOI: 10.3899/jrheum.130473
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