Low-Income Patients Skip Rheumatoid Arthritis Meds
Only one-fifth of patients at publicly funded clinics have adherence to oral meds of at least 80 percent
FRIDAY, June 28 (HealthDay News) -- Electronic monitoring shows that ethnically diverse and economically disadvantaged patients with rheumatoid arthritis (RA) have low adherence to oral disease-modifying antirheumatic drugs (DMARDs) and poorer outcomes, according to a study published in the June issue of Arthritis & Rheumatism.
Christian A. Waimann, M.D., of the University of Texas MD Anderson Cancer Center in Houston, and colleagues conducted a two-year prospective cohort study to examine adherence to oral drug therapies and outcomes in patients with RA who received care at publicly funded clinics. Intake of oral RA medications was monitored in 107 patients using the Medication Event Monitoring System, an electronic medication monitoring system. The Disease Activity Score in 28 joints (DAS28) and radiographic scores of joint damage were used to assess outcomes.
The researchers found that patients received 64 percent of correct doses for DMARDs and 70 percent of correct doses for prednisone. Twenty-three patients (21 percent) had adherence to oral medications averaging 80 percent or greater. Across two years of follow-up, patients with at least 80 percent adherence to oral drug therapy had significantly better mean DAS28 values (3.28 versus 4.09) and less radiographic evidence of joint damage at 12 months compared with baseline.
"Our findings should alert physicians about the need to integrate adherence assessments into daily practice, to explore potential barriers to non-adherence, and to engage in discussions with patients to highlight the importance of taking medications as prescribed to reach therapeutic target goals," the authors write.
Abstract (http://onlinelibrary.wiley.com/doi/10.1002/art.37917/abstract )Full Text (subscription or payment may be required) (http://onlinelibrary.wiley.com/doi/10.1002/art.37917/full )