Adherence to Methotrexate therapy in Rheumatoid Arthritis | [Pakistan Journal of Medical Sciences • 2016]

Author(s):

1. Nasim Arshad: Division of Rheumatology,Fatima Memorial Hospital, Shadman.Lahore, Pakistan

2. Nighat Mir Ahmad: Division of Rheumatology,Fatima Memorial Hospital, Shadman.Lahore, Pakistan

3. Muhammad Ahmed Saeed: Division of Rheumatology,Fatima Memorial Hospital, Shadman.Lahore, Pakistan

4. Saira Khan: Division of Rheumatology,Fatima Memorial Hospital, Shadman.Lahore, Pakistan

5. Shabnam Batool: Division of Rheumatology,Fatima Memorial Hospital, Shadman.Lahore, Pakistan

6. Sumaira Farman: Division of Rheumatology,Fatima Memorial Hospital, Shadman.Lahore, Pakistan

Abstract:

Objective: To determine adherence to methotrexate (MTX) therapy in patients with Rheumatoid Arthritis (RA) and to identify factors that promote either adherence or non adherence. Methods: One hundred Rheumatoid Arthritis patients on MTX for at least two months were enrolled. Questionnaire was completed by direct interview. Details recorded were, demographics (age, sex, education, monthly income), disease duration, duration on MTX and current dose. Disease Activity Score on 28 joint counts (DAS 28) at the current visit, concomitant drugs taken and number of doses of MTX missed in the previous 8 weeks were noted. Non adherence was defined as omission of any three or more prescribed doses of MTX in previous 8 week. Patients were asked for the factors that motivated their adherence to MTX as well as factors for non adherence. Presence of side effects due to MTX was also recorded. Result: Non adherence was found among 23% of cases. Patients of low socioeconomic group (p <0.0001) and on MTX for longer duration (p <0.001) had higher non adherence. Non adherent patients had significantly higher disease activity as measured by DAS 28 (p<0.001). Good counseling and education by the doctor was a strong predictor of adherence (p <0.001). Lack of affordability (p <0.001); lack of availability at local pharmacy (p <0.001); lack of family support (p <0.001) and lack of awareness regarding need and importance of MTX (p < 0.001were found as significant factors for non adherence. Conclusion: MTX non adherence in RA is noted in about one fourth of study group. Various economical and social issues lead to non adherence but good patient education and counseling by doctor could promote adherence in this study group.

Page(s): 413-417

DOI: 10.12669/pjms.322.9566

Published: Journal: Pakistan Journal of Medical Sciences, Volume: 32, Issue: 2, Year: 2016

Keywords:

Methotrexate , Rheumatoid Arthritis , Adherence

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