Non-adherence to pharmacotherapy and its associated factors in outpatients with rheumatoid arthritis

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Anan S. Jarab
Shrouq R. Abu Heshmeh
Walid A. Al-Qerem
Tareq L. Mukattash
Rami Beiram
Salahdein Aburuz


medication adherence, medication beliefs, rheumatoid arthritis, pharmaceutical care, Jordan


Background: Despite the availability of effective pharmacotherapy for the management of rheumatoid arthritis (RA), health outcomes are suboptimal due to poor adherence to the prescribed treatment. Limited research has been conducted to investigate medication non-adherence and its associated factors among patients with RA. Objective: This study aimed to assess medication adherence and to explore the factors associated with medication non-adherence among outpatients with RA in Jordan. Methods: The current cross-sectional study was conducted at outpatient rheumatology clinics at two teaching hospitals in Jordan. Variables including socio-demographics and biomedical variables, in addition to disease and medication characteristics, were collected using medical records and custom-designed questionnaire. Medication adherence was assessed using the validated 5-item Compliance Questionnaire for Rheumatology. Stepwise Logistic Regression analysis was performed to identify the factors that are independently and significantly associated with medication non-adherence. Results: A total of 261 patients participated in the study, from which, 43.3% were found non-adherent. Binary regression analysis results revealed that low monthly income (OR= 0.239, CI= 0.130-0.440, P<0.01), the presence of chronic respiratory disease (OR= 2.727, CI= 1.059-7.022, P<0.05), lower medication necessity scores (OR= 1.177, CI= 1.10-1.259, P<0.01) and higher concerns about RA medications (OR= 0.917, CI= 0.860-0.978, P<0.01) were significant and independent predictors of medication non-adherence in patients with RA. Conclusion: Future pharmaceutical care and clinical pharmacy service programs should emphasize medications benefits and minimizing medication-related concerns by selecting safe medications and providing guidance on mitigating side effects, particularly for RA patients who have low income and those who suffer from other comorbid diseases.

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