Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study
Objective This analysis explored the association of treatment adherence with beliefs about medication, patient demographic and disease characteristics and medication types in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) to develop adherence prediction models.Me...
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BMJ Publishing Group
2019-06-01
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| Series: | RMD Open |
| Online Access: | https://rmdopen.bmj.com/content/5/1/e000585.full |
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| author | Philip J Mease Joachim Sieper Josef S Smolen Dafna Gladman H Patrick McNeil Maja Hojnik Pascal Nurwakagari John Weinman |
| author_facet | Philip J Mease Joachim Sieper Josef S Smolen Dafna Gladman H Patrick McNeil Maja Hojnik Pascal Nurwakagari John Weinman |
| author_sort | Philip J Mease |
| collection | DOAJ |
| description | Objective This analysis explored the association of treatment adherence with beliefs about medication, patient demographic and disease characteristics and medication types in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) to develop adherence prediction models.Methods The population was a subset from ALIGN, a multicountry, cross-sectional, self-administered survey study in adult patients (n=7328) with six immune-mediated inflammatory diseases who were routinely receiving systemic therapy. Instruments included Beliefs about Medicines Questionnaire (BMQ) and 4-item Morisky Medication Adherence Scale (MMAS-4©), which was used to define adherence.Results A total of 3390 rheumatological patients were analysed (RA, n=1943; PsA, n=635; AS, n=812). Based on the strongest significant associations, the adherence prediction models included type of treatment, age, race (RA and AS) or disease duration (PsA) and medication beliefs (RA and PsA, BMQ-General Harm score; AS, BMQ-Specific Concerns score). The models had cross-validated areas under the receiver operating characteristic curve of 0.637 (RA), 0.641 (PsA) and 0.724 (AS). Predicted probabilities of full adherence (MMAS-4©=4) ranged from 5% to 96%. Adherence was highest for tumour necrosis factor inhibitors versus other treatments, older patients and those with low treatment harm beliefs or concerns. Adherence was higher in white patients with RA and AS and in patients with PsA with duration of disease <9 years.Conclusions For the first time, simple medication adherence prediction models for patients with RA, PsA and AS are available, which may help identify patients at high risk of non-adherence to systemic therapies.Trial registration number ACTRN12612000977875. |
| format | Article |
| id | doaj-art-e1f97073fc5d4677b6fc1e4985940bf0 |
| institution | DOAJ |
| issn | 2056-5933 |
| language | English |
| publishDate | 2019-06-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | RMD Open |
| spelling | doaj-art-e1f97073fc5d4677b6fc1e4985940bf02025-08-20T02:39:16ZengBMJ Publishing GroupRMD Open2056-59332019-06-015110.1136/rmdopen-2017-000585Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional studyPhilip J Mease0Joachim Sieper1Josef S Smolen2Dafna Gladman3H Patrick McNeil4Maja Hojnik5Pascal Nurwakagari6John Weinman74 Swedish Medical Center and University of Washington, Seattle, Washington, USA5 Department of Rheumatology, Charité Universitätsmedizin Berlin, Berlin, GermanyDivision of Rheumatology, Department of Internal Medicine III, Medical University of Vienna, Wien, AustriaDepartment of Medicine, University Health Network Schroeder Arthritis Institute, Krembil Research Institute, Toronto Western Hospital, Toronto, Ontario, Canada3 Department of Clinical Medicine, Faculty of Medicine and Health Sciences, Macquarie University, Sydney, New South Wales, AustraliaEli Lilly and Company, Indianapolis, Indiana, USA7 Medical Department, AbbVie Deutschland GmbH & Co. KG, Wiesbaden, Germany8 Institute of Pharmaceutical Science, King`s College London, London, UKObjective This analysis explored the association of treatment adherence with beliefs about medication, patient demographic and disease characteristics and medication types in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) to develop adherence prediction models.Methods The population was a subset from ALIGN, a multicountry, cross-sectional, self-administered survey study in adult patients (n=7328) with six immune-mediated inflammatory diseases who were routinely receiving systemic therapy. Instruments included Beliefs about Medicines Questionnaire (BMQ) and 4-item Morisky Medication Adherence Scale (MMAS-4©), which was used to define adherence.Results A total of 3390 rheumatological patients were analysed (RA, n=1943; PsA, n=635; AS, n=812). Based on the strongest significant associations, the adherence prediction models included type of treatment, age, race (RA and AS) or disease duration (PsA) and medication beliefs (RA and PsA, BMQ-General Harm score; AS, BMQ-Specific Concerns score). The models had cross-validated areas under the receiver operating characteristic curve of 0.637 (RA), 0.641 (PsA) and 0.724 (AS). Predicted probabilities of full adherence (MMAS-4©=4) ranged from 5% to 96%. Adherence was highest for tumour necrosis factor inhibitors versus other treatments, older patients and those with low treatment harm beliefs or concerns. Adherence was higher in white patients with RA and AS and in patients with PsA with duration of disease <9 years.Conclusions For the first time, simple medication adherence prediction models for patients with RA, PsA and AS are available, which may help identify patients at high risk of non-adherence to systemic therapies.Trial registration number ACTRN12612000977875.https://rmdopen.bmj.com/content/5/1/e000585.full |
| spellingShingle | Philip J Mease Joachim Sieper Josef S Smolen Dafna Gladman H Patrick McNeil Maja Hojnik Pascal Nurwakagari John Weinman Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study RMD Open |
| title | Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study |
| title_full | Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study |
| title_fullStr | Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study |
| title_full_unstemmed | Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study |
| title_short | Predicting adherence to therapy in rheumatoid arthritis, psoriatic arthritis or ankylosing spondylitis: a large cross-sectional study |
| title_sort | predicting adherence to therapy in rheumatoid arthritis psoriatic arthritis or ankylosing spondylitis a large cross sectional study |
| url | https://rmdopen.bmj.com/content/5/1/e000585.full |
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