Strong belief in medication necessity tied to better adherence in RA patients

A strong belief in the necessity of medication is associated with better adherence to oral disease-modifying antirheumatic drugs (DMARDs) or prednisone, while higher self-efficacy correlates with poor adherence, in a diverse cohort of patients with rheumatoid arthritis (RA), suggests a study.

Of the 362 patients who reported taking a synthetic DMARD and/or prednisone, 14 percent and 21 percent reported poor adherence to oral DMARD or prednisone and biologics, respectively. Furthermore, 64 percent of patients reported concern about taking medicines, 81 percent about long-term effects and 47 percent about becoming too dependent on medicines.

Multivariate analyses revealed that the Beliefs about Medicines Questionnaire (BMQ) necessity score independently correlated with better adherence to oral DMARD or prednisone (adjusted odds ratio [aOR], 0.61; 95 percent CI, 0.41–0.91), whereas self-efficacy correlated with higher odds of poor adherence to oral medications (aOR, 1.23; 1.01–1.59).

On the other hand, there was no association between beliefs in medicines and self-efficacy and adherence to biologics.

“Providers can play important roles in eliciting patient beliefs about medications to improve adherence and ultimately health outcomes,” the authors said.

This study used data from a longitudinal observational cohort of persons with RA. Participants completed telephone interviews on self-reported adherence, self-efficacy, demographics and the BMQ, which evaluates beliefs in necessity and beliefs about taking medication. Bivariate and multivariate logistic regression identified associations of poor adherence to synthetic DMARD and prednisone as well as to biologic therapy, including medication concerns and necessity.