Personal Beliefs Affect Medication Adherence for RA Patients

A British study of rheumatoid arthritis (RA) patients found that 40% of those surveyed scored poorly on medication adherence, reinforcing the need to impress upon patients how important constancy is, one rheumatologist says.

Published online in May in Rheumatology, the paper, “The influence of behavioural and psychological factors on medication adherence over time in rheumatoid arthritis patients: A study in the biologics era,” involved 239 patients in England who were treated with adalimumab. Low adherence was reported by 23% of respondents, with 41% of respondents reporting low adherence during at least one time period.¹

The variation of patients who reported currently adhering poorly to medication guidelines vs. those who admitted they had struggled with adherence at some prior point is important, says Jennifer Stichman, MD, an assistant professor of general internal medicine at Denver Health and the University of Colorado, who has written about medication adherence for The Rheumatologist.

“This [variation] reinforces that asking about adherence on a regular basis is important,” Dr. Stichman adds.

The study concluded that rheumatologists’ paying more attention to the importance of psychological factors—particularly patients’ medication beliefs—could “have substantial clinical and health economic benefits in RA.”

“It all comes down to time,” Dr. Stichman says. Rheumatologists need to take time to flesh out how patients view medication and work from there. A screening question for adherence could be added to the introductory paperwork, for example.

“Medication beliefs are not part of the usual framework we [are] taught to ask patients about their medicines,” Dr. Stichman says. “Certainly, we are trained to ask about tolerability, side effects and efficacy, and I would add that the next step is to ask about adherence. There is value to clinicians in knowing that medication beliefs influence patient behavior because it can help us modify our behavior to elicit those beliefs.”

Richard Quinn is a freelance writer in New Jersey.

Reference

1. Morgan C, McBeth J, Cordingley L, et al. The influence of behavioural and psychological factors on medication adherence over time in rheumatoid arthritis patients: A study in the biologics era. Rheumatology (Oxford). 2015 May 13. pii: kev105. doi: 10.1093/rheumatology/kev105. [Epub ahead of print]