Table 1.

Rheumatologist-proposed definitions of adherence^* to ASAS recommendations¹⁰.

ASAS Item	Adherence Definition
Physiotherapy^**	Define “nonadherence” by satisfaction of 1 criterion (a): If by the 12-month followup visit, patient has had 0 visits to the physiotherapist
Extraarticular manifestations and comorbidities	Define “nonadherence” as by satisfaction of ≥ 1 of 5 criteria: If at a given study visit, a patient has a new diagnosis of uveitis AND has not had an ophthalmologist consult by the next study visit If at a given study visit, a patient has a new diagnosis of psoriasis AND has not had a dermatologist consult by the next study visit If at a given study visit, a patient has a new diagnosis of pustulosis AND has not had a dermatologist consult by the next study visit If at a given study visit, a patient has a new diagnosis of IBD AND has not had a gastroenterologist consult by the next study visit If at a given study visit, a patient has a new cardiovascular event and has not had a cardiologist consult by the next study visit
NSAID	Define “nonadherence” by satisfaction of ≥ 1 of 3 criteria: If patient received their first DMARD before their first NSAID If patient has diagnosis of renal insufficiency (i.e., creatinine clearance < 30 ml/min) and NSAID use is not interrupted within 15 days of that diagnosis (as assessed at next study visit) If patient has history of GI event other than dyspepsia and receives an NSAID or Cox inhibitor without a concomitant PPI
Glucocorticoids	Define “nonadherence” by satisfaction of 1 criterion (a): If at a given study visit, a patient is receiving oral prednisone or equivalent and has no history of uveitis, peripheral arthritis, or IBD
Disease-modifying antirheumatic drugs	Define “nonadherence” by satisfaction of ≥ 1 of 3 criteria: If patient has synovitis ≥ 3 at 2 consecutive visits and is not prescribed a DMARD at either of these visits If at a given study visit, a patient is receiving MTX and has no history of peripheral arthritis or psoriasis If at a given study visit, a patient is receiving SSZ and has no history of peripheral arthritis, IBD, or uveitis
Anti-TNF agents	Define “nonadherence” by satisfaction of ≥ 1 of 2 criteria: If at 2 consecutive study visits, patient has had at least 2 adequate therapeutic trials of NSAID (i.e., minimum 2 NSAID over a 4-week period in total since symptom onset), BASDAI is ≥ 4, PGA is ≥ 4, AND an anti-TNF agent has not been prescribed at the third visit If patient is receiving a biological agent other than anti-TNF^† (EXCEPTION: patients with psoriatic arthritis may receive a biologic other than anti-TNF, but then cannot receive a concomitant anti-TNF)

↵* Originally defined in Reference 10 as “compliance”.
↵** ASAS item is “Non-Pharmacological Therapy,” but was defined in Reference 10 exclusively on the basis of physiotherapy.
↵† No DESIR patients were receiving biological agents other than anti-TNF. ASAS: Assessment of Spondyloarthritis international Society; IBD: inflammatory bowel disease; DMARD: disease-modifying antirheumatic drugs; NSAID: nonsteroidal antiinflammatory drugs; GI: gastrointestinal; PPI: proton pump inhibitor; MTX: methotrexate; SSZ: sulfasalazine; BASDAI: Bath Ankylosing Spondylitis Disease Activity Index; PGA: physician’s global assessment; anti-TNF: antitumor necrosis factor; DESIR: Devenir des Spondylarthropathies Indifférenciées Récentes.