Hashmi Farzana, Haroon Muhammad, Ullah Saadat, Asif Sadia, Javed Saba, Tayyab Zaid
Department of Rheumatology, Fatima Memorial Hospital (FMH) College of Medicine and Dentistry, Lahore, PAK.
Cureus. 2022 Jun 10;14(6):e25835. doi: 10.7759/cureus.25835. eCollection 2022 Jun.
Aims We aimed to assess the level of non-adherence and poor illness perception among rheumatoid arthritis (RA) patients. Additionally, we examined their associations with clinical indicators and outcomes. Methods This was a cross-sectional study conducted using data collected at the time of patient enrolment in the Pakistan Registry of Rheumatic Diseases (PRIME) registry. A wide range of clinical variables was studied. To measure adherence, we used the Urdu version of the General Medication Adherence Scale (GMAS), which has recently been validated in RA patients. A Brief Illness Perception Questionnaire (BIPQ) was used to measure illness perception. Results The data of consecutive 320 RA patients were reviewed. Thirty-six percent of the cohort (n=116) was noted to have non-adherence. On multiple logistic regression analysis, a significant association of non-adherence was noted with moderate-to-severe stress (odds ratio {OR}: 1.85, confidence interval {CI}: 1.04-3.2), DAS-28 scores (OR: 1.83, CI: 1.52-2.21), Health Assessment Questionnaire (HAQ) scores (OR: 1.77, CI: 1.07-2.92), and deformed joint counts (OR: 1.30, CI: 1.15-1.46). Additionally, non-adherence due to "patient behavior" had a significant association with the male gender (OR: 0.48, CI: 0.26-0.87), unemployment (OR: 1.82, CI: 1.07-3.10), and stress at home (OR: 2.17, CI: 1.35-3.49). Twenty-six percent of the cohort (n=86) was noted to have the most negative illness perception, and on multiple logistic regression analysis, it was significantly associated with male gender (OR: 0.24, CI: 0.11-0.53), age of onset of arthritis (OR: 0.96, CI: 0.94-0.99), and worse HAQ scores (OR: 3.7, CI: 2.2-6.1). Conclusions Important adverse factors contributing to non-adherence and negative illness perception highlighted in this study were stress at home, female gender, and younger age of patients.
目的 我们旨在评估类风湿关节炎（RA）患者的不依从水平和不良疾病认知情况。此外，我们还研究了它们与临床指标及结局之间的关联。方法 这是一项横断面研究，使用在巴基斯坦风湿病登记处（PRIME）登记患者入组时收集的数据。研究了广泛的临床变量。为衡量依从性，我们使用了通用药物依从性量表（GMAS）的乌尔都语版本，该量表最近已在RA患者中得到验证。使用简短疾病认知问卷（BIPQ）来衡量疾病认知。结果 回顾了连续320例RA患者的数据。该队列中有36%（n = 116）的患者存在不依从情况。在多因素逻辑回归分析中，发现不依从与中度至重度压力（比值比{OR}：1.85，置信区间{CI}：1.04 - 3.2）、疾病活动度评分28（DAS - 28）（OR：1.83，CI：1.52 - 2.21）、健康评估问卷（HAQ）评分（OR：1.77，CI：1.07 - 2.92）以及关节畸形数量（OR：1.30，CI：1.15 - 1.46）显著相关。此外，因“患者行为”导致的不依从与男性性别（OR：0.48，CI：0.26 - 0.87）、失业（OR：1.82，CI：1.07 - 3.10）以及家庭压力（OR：2.17，CI：1.35 - 3.49）显著相关。该队列中有26%（n = 86）的患者具有最负面的疾病认知，在多因素逻辑回归分析中，其与男性性别（OR：0.24，CI：0.11 - 0.53）、关节炎发病年龄（OR：0.96，CI：0.94 - 0.99）以及更差的HAQ评分（OR：3.7，CI：2.2 - 6.1）显著相关。结论 本研究中强调的导致不依从和负面疾病认知的重要不利因素是家庭压力、女性性别以及患者较年轻的年龄。
