Non-adherence to pharmacotherapy and its associated factors in outpatients with rheumatoid arthritis

Pharmacy Practice

  • Anan S. Jarab1College of Pharmacy, Al Ain University, Abu Dhabi, United Arab Emirates., 2Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
  • Shrouq R. Abu Heshmeh2Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
  • Walid A. Al-Qerem3Department of Pharmacy, Faculty of Pharmacy, Al-Zaytoonah University of Jordan, Amman, Jordan.
  • Tareq L. Mukattash2Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan.
  • Rami Beiram4Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates.
  • Salah Aburuz4Department of Pharmacology and Therapeutics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates., 5Department of Clinical Pharmacy, Faculty of Pharmacy, The University of Jordan, Amman, Jordan.

Volume 21 Issue 2 Pages 1-8

DOI: 10.18549/PharmPract.2023.2.2822

Abstract

Background: Despite the availability of effective pharmacotherapy for the management of rheumatoid arthritis (RA), health outcomes are suboptimal due to poor adherence to the prescribed treatment. Limited research has been conducted to investigate medication non-adherence and its associated factors among patients with RA. Objective: This study aimed to assess medication adherence and to explore the factors associated with medication non-adherence among outpatients with RA in Jordan. Methods: The current cross-sectional study was conducted at outpatient rheumatology clinics at two teaching hospitals in Jordan. Variables including socio-demographics and biomedical variables, in addition to disease and medication characteristics, were collected using medical records and custom-designed questionnaire. Medication adherence was assessed using the validated 5-item Compliance Questionnaire for Rheumatology. Stepwise Logistic Regression analysis was performed to identify the factors that are independently and significantly associated with medication non-adherence. Results: A total of 261 patients participated in the study, from which, 43.3% were found non-adherent. Binary regression analysis results revealed that low monthly income (OR= 0.239, CI= 0.130-0.440, P<0.01), the presence of chronic respiratory disease (OR= 2.727, CI= 1.059-7.022, P<0.05), lower medication necessity scores (OR= 1.177, CI= 1.10-1.259, P<0.01) and higher concerns about RA medications (OR= 0.917, CI= 0.860-0.978, P<0.01) were significant and independent predictors of medication non-adherence in patients with RA. Conclusion: Future pharmaceutical care and clinical pharmacy service programs should emphasize medications benefits and minimizing medication-related concerns by selecting safe medications and providing guidance on mitigating side effects, particularly for RA patients who have low income and those who suffer from other comorbid diseases.

Keywords

  • medication adherence
  • medication beliefs
  • rheumatoid arthritis
  • pharmaceutical care
  • Jordan
Pharmacy Practice

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