Medication nonadherence in Korean patients with rheumatoid arthritis: the importance of belief about medication and illness perception
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Background/Aims: To investigate medication nonadherence in Korean patients with rheumatoid arthritis (RA) and analyze related factors. Methods: A total of 292 patients with RA participated in this study. Medication nonadherence, intentional or unintentional, was gauged via self-reported questionnaire. Patient perceptions of illness, treatment beliefs, and moods were measured via Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, and Patient Health Questionnaire-2, respectively. Demographic and clinical data were also collected. Multinomial regression analysis was used to assess the impact of demographic, clinical, and psychological factors on medication nonadherence. Results: The medication nonadherence rate was 54.1% (intentional, 21.6%; unintentional, 32.5%). Intentional nonadherence was reported most often in patients treated daily drugs (nonsteroidal anti-inflammatory drugs and/or disease-modifying antirheumatic drugs) (24.2%), and unintentional nonadherence was highest in patients receiving methotrexate (33.3%) (p = 0.872). In univariate analysis, beliefs in necessity and concerns of medication differed significantly in adherent and nonadherent patients (intentional or unintentional). When controlling for other factors that may impact medication nonadherence, less belief in necessity of medication (odds ratio [OR], 0.81; 95% confidence interval [CI], 0.68 to 0.95) and greater emotional response to disease (OR, 1.19; 95% CI, 1.01 to 1.40) were important predictors of intentional nonadherence. Conclusions: Medication nonadherence is common in Korean patients with RA. Less belief in necessity of medication and greater emotional response to disease were identified as key factors prompting intentional nonadherence. These factors may be strategically targeted to improve medication adherence rates and subsequent clinical outcomes.
Abstract
Background/Aims: To investigate medication nonadherence in Korean patients with rheumatoid arthritis (RA) and analyze related factors. Methods: A total of 292 patients with RA participated in this study. Medication nonadherence, intentional or unintentional, was gauged via self-reported questionnaire. Patient perceptions of illness, treatment beliefs, and moods were measured via Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, and Patient Health Questionnaire-2, respectively. Demographic and clinical data were also collected. Multinomial regression analysis was used to assess the impact of demographic, clinical, and psychological factors on medication nonadherence. Results: The medication nonadherence rate was 54.1% (intentional, 21.6%; unintentional, 32.5%). Intentional nonadherence was reported most often in patients treated daily drugs (nonsteroidal anti-inflammatory drugs and/or disease-modifying antirheumatic drugs) (24.2%), and unintentional nonadherence was highest in patients receiving methotrexate (33.3%) (p = 0.872). In univariate analysis, beliefs in necessity and concerns of medication differed significantly in adherent and nonadherent patients (intentional or unintentional). When controlling for other factors that may impact medication nonadherence, less belief in necessity of medication (odds ratio [OR], 0.81; 95% confidence interval [CI], 0.68 to 0.95) and greater emotional response to disease (OR, 1.19; 95% CI, 1.01 to 1.40) were important predictors of intentional nonadherence. Conclusions: Medication nonadherence is common in Korean patients with RA. Less belief in necessity of medication and greater emotional response to disease were identified as key factors prompting intentional nonadherence. These factors may be strategically targeted to improve medication adherence rates and subsequent clinical outcomes.
참고문헌 (22)
- American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines, "Guidelines for the management of rheumatoid arthritis: 2002 update", Arthritis Rheum, 46, pp.328~346 (2002)[DOI]
- Buckley CD, "Science, medicine, and the future: treatment of rheumatoid arthritis", BMJ, 315, pp.236~238 (1997)[DOI]
- Smolen JS, "Treating rheumatoid arthritis to target: recommendations of an international task force", Ann Rheum Dis, 69, pp.631~637 (2010)[DOI]
- Harrold LR, "Medication adherence of patients with selected rheumatic conditions: a systematic review of the literature", Semin Arthritis Rheum, 38, pp.396~402 (2009)[DOI]
- Park DC, "Medication adherence in rheumatoid arthritis patients: older is wiser", J Am Geriatr Soc, 47, pp.172~183 (1999)[DOI]
- Viller F, "Compliance with drug therapy in rheumatoid arthritis: a longitudinal European study", Joint Bone Spine, 67, pp.178~182 (2000)
- Neame R, "Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis", Rheumatology (Oxford), 44, pp.762~767 (2005)[DOI]
- Tuncay R, "Factors affecting drug treatment compliance in patients with rheumatoid arthritis", Rheumatol Int, 27, pp.743~746 (2007)[DOI]
- Garcia-Gonzalez A, "Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus", Clin Rheumatol, 27, pp.883~889 (2008)[DOI]
- van den Bemt BJ, "Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease modifying antirheumatic drugs", J Rheumatol, 36, pp.2164~2170 (2009)[DOI]
- Contreras-Yanez I, "Inadequate therapy behavior is associated to disease flares in patients with rheumatoid arthritis who have achieved remission with disease-modifying antirheumatic drugs", Am J Med Sci, 340, pp.282~290 (2010)[DOI]
- Grijalva CG, "Adherence to disease-modifying antirheumatic drugs and the effects of exposure misclassification on the risk of hospital admission", Arthritis Care Res (Hoboken), 62, pp.730~734 (2010)[DOI]
- Treharne GJ, "Medication adherence in rheumatoid arthritis: effects of psychosocial factors", Psychol Health Med, 9, pp.337~349 (2004)[DOI]
- 김영택, "지역사회 뇌졸중 환자들의 이차 예방을 위한 치료 지속률과 약물 순응도 관련 요인", 농촌의학.지역보건, 40(1), pp.9~20 (2015), 한국농촌의학.지역보건학회[DOI]
- Lowe B, "Detecting and monitoring depression with a two-item questionnaire (PHQ-2)", J Psychosom Res, 58, pp.163~171 (2005)[DOI]
- Broadbent E, "The brief illness perception questionnaire", J Psychosom Res, 60, pp.631~637 (2006)[DOI]
- Horne R, "The Beliefs about Medicines Questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication", Psychol Health, 14, pp.1~24 (1999)[DOI]
- Horne R, "Do hypertensive patients' beliefs about their illness and treatment influence medication adherence and quality of life?", J Hum Hypertens, 15(Suppl 1), pp.S65~S68 (2001)[DOI]
- Johnson MJ, "The medication adherence model: a guide for assessing medication taking", Res Theory Nurs Pract, 16, pp.179~192 (2002)[DOI]
- Wroe AL, "Intentional and unintentional nonadherence: a study of decision making", J Behav Med, 25, pp.355~372 (2002)[DOI]
- Hughes LD, "Patients that report high adherence to DMARDs show higher perceptions of serious consequences and negative emotional response to rheumatoid arthritis than patients with low self reported adherence", Ann Rheum Dis, 70(Suppl 3), pp.760~ (2011)[DOI]
- Sabate E, "Adherence to Long-Term Therapies: Evidence for Action" (2003)