Division of Rheumatology, Department of Medicine III, Medical University of Vienna and Hietzing Hospital, Vienna, Austria.
Department of Medicine, Toronto Western Hospital, Toronto, Ontario, Canada.
RMD Open. 2019 Jan 11;5(1):e000585. doi: 10.1136/rmdopen-2017-000585. eCollection 2019.
This analysis explored the association of treatment adherence with beliefs about medication, patient demographic and disease characteristics and medication types in rheumatoid arthritis (RA), psoriatic arthritis (PsA) or ankylosing spondylitis (AS) to develop adherence prediction models.
The population was a subset from ALIGN, a multicountry, cross-sectional, self-administered survey study in adult patients (n=7328) with six immune-mediated inflammatory diseases who were routinely receiving systemic therapy. Instruments included Beliefs about Medicines Questionnaire (BMQ) and 4-item Morisky Medication Adherence Scale (MMAS-4), which was used to define adherence.
A total of 3390 rheumatological patients were analysed (RA, n=1943; PsA, n=635; AS, n=812). Based on the strongest significant associations, the adherence prediction models included type of treatment, age, race (RA and AS) or disease duration (PsA) and medication beliefs (RA and PsA, BMQ-General score; AS, BMQ-Specific score). The models had cross-validated areas under the receiver operating characteristic curve of 0.637 (RA), 0.641 (PsA) and 0.724 (AS). Predicted probabilities of full adherence (MMAS-4=4) ranged from 5% to 96%. Adherence was highest for tumour necrosis factor inhibitors versus other treatments, older patients and those with low treatment harm beliefs or concerns. Adherence was higher in white patients with RA and AS and in patients with PsA with duration of disease <9 years.
For the first time, simple medication adherence prediction models for patients with RA, PsA and AS are available, which may help identify patients at high risk of non-adherence to systemic therapies.
ACTRN12612000977875.
本分析探讨了在类风湿关节炎（RA）、银屑病关节炎（PsA）或强直性脊柱炎（AS）中，治疗依从性与药物信念、患者人口统计学和疾病特征以及药物类型之间的关联，以开发依从性预测模型。
该人群为多国家、横断面、自我管理的 ALIGN 研究的亚组，纳入了 7328 例接受常规全身治疗的成年免疫介导性炎症性疾病患者。评估工具包括药物信念问卷（BMQ）和 4 项 Morisky 用药依从性量表（MMAS-4），后者用于定义依从性。
共分析了 3390 例风湿病患者（RA，n=1943；PsA，n=635；AS，n=812）。基于最强的显著关联，依从性预测模型包括治疗类型、年龄、种族（RA 和 AS）或疾病持续时间（PsA）和药物信念（RA 和 PsA，BMQ-一般评分；AS，BMQ-特异评分）。模型的受试者工作特征曲线下交叉验证面积为 0.637（RA）、0.641（PsA）和 0.724（AS）。完全依从（MMAS-4=4）的预测概率范围为 5%至 96%。肿瘤坏死因子抑制剂的依从性最高，其次是其他治疗方法，年龄较大和治疗危害信念或担忧较低的患者依从性较高。RA 和 AS 的白人患者以及疾病持续时间<9 年的 PsA 患者依从性较高。
首次为 RA、PsA 和 AS 患者提供了简单的药物依从性预测模型，这可能有助于识别系统治疗依从性差的高风险患者。
ACTRN12612000977875。
