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Determinants of methotrexate adherence in rheumatoid arthritis patients

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Abstract

In rheumatoid arthritis (RA) patients, weekly intake of methotrexate (MTX) is the basic drug treatment. This observational study aims to investigate how many RA patients are adherent in terms of MTX intake and to identify determinants of non-adherence. Intake of MTX (orally or via injection) was recorded in 129 RA patients with an electronic monitoring system (MEMS®) during 16 weeks. In addition, two adherence questionnaires, the Medication Adherence Report Scale (MARS-5) and the Compliance-Questionnaire-Rheumatology (CQR) as well as a visual analogue scale (VAS) measuring MTX adherence, were administered to these patients. As possible determinants of adherence, data on demographics, disease and treatment characteristics, depression, illness cognitions, motivation, and social support were collected. Of all participants, 58 % were fully adherent and 75 % skipped at most one dose during 16 weeks. A better mental health status and suffering from comorbidities had a positive effect on adherence, while living alone had a negative effect. These three predictors explained 30 % of the variance in MTX adherence. Of the three self-report medication adherence measures, the VAS correlated the highest with the results of the electronic monitoring system (r = 0.552, p = 0.01). A relatively high adherence rate was observed in RA patients treated with MTX. The determinants identified by this study could be used to screen patients at risk for non-adherence. A simple VAS scale seems to be an acceptable way for a preliminary screening of MTX adherence.

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Acknowledgments

This research received support from a scientific grant awarded by Merck Sharp & Dohme (MSD) Belgium.

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Authors and Affiliations

  1. Department of Immunology-Rheumatology-Allergology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium

    Ellen De Cuyper & Luc S. De Clerck

  2. Faculty of Medicine and Health Sciences, Department of Immunology-Rheumatology-Allergology, University of Antwerp, Campus Drie Eiken T4.08, Universiteitsplein 1, 2610, Antwerpen, Belgium

    Luc S. De Clerck

  3. Institute of Psychology, Medical and Health Psychology, Leiden University, Pieter de la Courtgebouw, room 2A05A, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands

    Veronique De Gucht & Stan Maes

  4. Faculty of Medicine and Health Sciences, Center for Research and Innovation in Care (CRIC), University of Antwerp, Campus Drie Eiken S.143, Universiteitsplein 1, 2610, Antwerpen, Belgium

    Yoleen Van Camp

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  1. Ellen De Cuyper
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  2. Veronique De Gucht
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  3. Stan Maes
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  4. Yoleen Van Camp
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  5. Luc S. De Clerck
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Correspondence to Ellen De Cuyper or Luc S. De Clerck.

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None of the authors have a financial relationship with MSD nor other relationships or activities that could appear to have influenced the submitted work. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

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De Cuyper, E., De Gucht, V., Maes, S. et al. Determinants of methotrexate adherence in rheumatoid arthritis patients. Clin Rheumatol 35, 1335–1339 (2016). https://doi.org/10.1007/s10067-016-3182-4

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  • DOI: https://doi.org/10.1007/s10067-016-3182-4

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