Rate and causes of noncompliance with disease-modifying antirheumatic drug regimens in patients with rheumatoid arthritis

Abstract

© 2020, International League of Associations for Rheumatology (ILAR). Introduction/objectives: To determine the prevalence and factors associated with medication noncompliance by Thai patients with rheumatoid arthritis (RA). Methods: This prospective cohort study enrolled 443 adult RA patients (≥ 18 years) who were followed up at the outpatient rheumatology clinics of Siriraj Hospital and Phramongkutklao Hospital between May 2018 and December 2019. Medication noncompliance was assessed using the Compliance Questionnaire for Rheumatology–19 (CQR-19). A score of 0 indicated complete noncompliance, whereas a score of 100 indicated a perfect compliance. An unsatisfactory compliance was arbitrarily defined as a taking compliance of ≤ 80%. Results: The prevalence of medication noncompliance was 22.1%. The most common cause was forgetting to take medications due to a busy work schedule. In a univariate analysis, the factors that were significantly related to medication noncompliance were age, income, number of comorbidities, functional status as measured by the Health Assessment Questionnaire (HAQ), number of prescribed pills per day, and number of types of prescribed medications per day. In a subsequent backward stepwise multiple logistic regression analysis, only 2 factors were found to be negatively associated with medication noncompliance: age (risk ratio, 0.98; 95% CI, 0.96–0.99; p, 0.048) and HAQ (risk ratio, 0.62; 95% CI, 0.39–0.98; p, 0.041). Conclusions: Medication noncompliance is common in patients with RA. As this may lead to unfavorable outcomes, patient education related to drug compliance should be addressed and emphasized in daily practice.• Medication noncompliance is common in patients with RA.• Forgetting to take pills was the most frequent explanation offered for noncompliance.• All patients should be strongly encouraged to comply with the recommended drug regimens.