ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2021
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2382

Adherence to Dmards in the First Six Months of Treatment in Early Arthritis Patients; Comparing Three Adherence Measures

Annelieke Pasma1, Ethan den Boer2, Adriaan van 't Spijker3, Reinier Timman3, Jan van Busschbach3 and J.M.W. Hazes4, 1Rheumatology, Erasmus MC University Medical Center, Rotterdam, Netherlands, 2Clinical Chemistry, Erasmus MC University Medical Center, Rotterdam, Netherlands, 3Psychiatry, section Medical Psychology and Psychotherapy, Erasmus MC University Medical Center, Rotterdam, Netherlands, 4Rheumatology, Erasmus University Medical Center, Rotterdam, Netherlands

Meeting: 2014 ACR/ARHP Annual Meeting

Keywords: Compliance, DMARDs and Early Rheumatoid Arthritis

  • Tweet
  • Email
  • Print
Session Information

Session Title: Rheumatoid Arthritis - Clinical Aspects (ACR): Impact of Various Interventions and Therapeutic Approaches

Session Type: Abstract Submissions (ACR)

Background/Purpose Non-adherence to DMARDs is an important indicator for the effectiveness of treatment in early arthritis patients. Reported non-adherence rates differ widely, because studies use different adherence measures. Electronic measurement is considered as a ‘gold standard’, but other measures have other attractive features. This study compared three methods to ascertain how non-adherence should be measured: the Compliance Questionnaire Rheumatology (CQR), the intracellular uptake of methotrexate (MTX) in the form of methotrexate-polyglutamates (MTX-PGs) and Medication Event Monitoring Systems (MEMS).
Methods Adult patients diagnosed with arthritis who started DMARDs were included in a cohort study. MTX-PGs were collected and the CQR was filled out after three and six months of treatment. Non-adherence was continuously measured with MEMS. When there was a discordance between the observed opening and the expected opening of the MEMS cap, this was assigned as a non-adherence event. The CQR and MEMS were compared with Pearson correlations. Sensitivity and specificity of adherence measured with MEMS against a CQR discriminant cut-off score was calculated at three and six months. To assess the influence of adherence measured with MEMS on MTX-PGs, a multivariate linear regression (backward selection) with MTX-PGs as dependent variable and with non-adherence measured with MEMS the 12 weeks before MTX-PG measurement (continuous score), age, gender, time of treatment and dosage as independent variables was performed.
Results Two hundred and one patients entered the study. As measured with MEMS, non-adherence rates varied over time and between different DMARDs (figure 1). For sulfasalazine and hydroxychloroquine, the non-adherence rates were highest. For all medicines, except for prednisone, the non-adherence rate rose over time. The CQR did not correlate with MEMS at any of the time points of therapy. At both time points, the ROC curves showed no discrimination between non-adherence measured with MEMS against the CQR cut-off score. Non-adherence (B 0.548, p=0.035), time of treatment (B 0.947, p=0.006) and age (B 2.052, p<0.000) significantly contributed to MTX-PGs, but only accounted for 18.8% of explained variance.
Conclusion Non-adherence rates for prednisone are lowest and stable. This might be explained by the fact that patients immediately experience the effect of prednisone, and that most patients tapered prednisone. The non-adherence rate for MTX was low, probably because rheumatologists emphasize the necessity of MTX. The CQR is not associated with MEMS, but MTX-PGs are weakly associated with MEMS. This can be due to several reasons, such as individual differences in the uptake of MTX. We have to learn more about the uptake of MTX over time per patient, before we can use MTX-PGs in daily practice as a non-adherence measure.


Disclosure:

A. Pasma,
None;

E. den Boer,
None;

A. van ‘t Spijker,
None;

R. Timman,
None;

J. van Busschbach,
None;

J. M. W. Hazes,
None.

  • Tweet
  • Email
  • Print

« Back to 2014 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/adherence-to-dmards-in-the-first-six-months-of-treatment-in-early-arthritis-patients-comparing-three-adherence-measures/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts during your browser session by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2022 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies