The Influence of Socio-Demographic Factors, Lifestyle and Psychiatric Indicators on Adherence to Treatment of Patients with Rheumatoid Arthritis: A Cross-Sectional Study

Medicina (Kaunas). 2020 Apr 14;56(4):178. doi: 10.3390/medicina56040178.

Abstract

Background and Objectives: Rheumatoid arthritis (RA) is a severe autoimmune disease characterized by chronic inflammation of the joints accompanied by the progressive deformation and destruction of cartilage and joint bones. This study aims to gain insight into the outcomes related to adherence in patients with rheumatoid arthritis. Predicting the medication adherence in RA patients is a key point to improve the treatment outcome. Materials and Methods: A number of 119 Romanian patients with RA were included and divided into two groups: first group included 79 patients treated with conventional therapy and second group included 40 patients treated with biologic therapy. A CQR-9 (compliance questionnaire rheumatology with nine items) and PDSQ (psychiatric diagnostic screening questionnaire) were performed to assess correlations between medication adherence, patient sociodemographic variables, 11 psychiatric scales (major depressive disorder, posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, psychosis, agoraphobia, social phobia, drug abuse/dependence, generalized anxiety disorder, somatization disorder, hypochondriasis) and lifestyle (bulimia, alcohol intake). Results: Whilst modelling factors associated with adherence, it was found that women and patients with higher education are more adherent. From the psychiatric indicators, only major depressive disorder and post-traumatic stress disorder were found to be positively correlated with therapeutic adherence. None of the assessed lifestyle factors influenced the adherence of RA patients. Conclusion: The knowledge of factors that impact on treatment adherence can be useful for clinicians to guide patient-centred care.

Keywords: CQR-9; PDSQ; lifestyle; major depressive disorder; rheumatoid arthritis; socio-demographic factors; treatment adherence.

MeSH terms

  • Adult
  • Aged
  • Arthritis, Rheumatoid / epidemiology
  • Arthritis, Rheumatoid / psychology*
  • Arthritis, Rheumatoid / therapy*
  • Cross-Sectional Studies
  • Demography / methods
  • Demography / statistics & numerical data
  • Humans
  • Life Style*
  • Middle Aged
  • Psychometrics / instrumentation
  • Psychometrics / methods
  • Romania / epidemiology
  • Severity of Illness Index
  • Surveys and Questionnaires
  • Treatment Adherence and Compliance / psychology*
  • Treatment Adherence and Compliance / statistics & numerical data
  • Treatment Outcome