Session Title: Rheumatoid Arthritis - Clinical Aspects Poster Session III
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Adherence to disease modifying anti-rheumatic drug (DMARD) therapy is suboptimal in patients with rheumatoid arthritis (RA). Efficient, low-cost measures are required for optimal monitoring of medication adherence in the rheumatology clinic. Self-report tools are the most efficient and cost-effective measures available. Recently, a 5-item version of the Compliance Questionnaire Rheumatology (CQR5) was developed from the original 19-item version to reduce patient burden1. Reliability of CQR5 over time has not been evaluated, nor has its association with other factors that can impact medication taking. In a sample of RA patients, we investigated 1) test-retest reliability of CQR5 and 2) correlation of CQR5 with psychosocial and physical factors known to influence adherence.
Methods: RA patients (disease duration ≥ 1 yr) taking at least one DMARD were randomly selected from a rheumatology clinic database. Patients were assessed at baseline and 2 weeks. Demographic data were collected at baseline. At each visit, medication adherence was assessed with CQR5. Each item on the CQR5 was scored on a 4-point Likert scale (1 = strongly disagree, 4 = strongly agree). Scores for each item were summed into a total score which varied between 0 and 20. Higher scores indicated greater adherence. Psychosocial measures were evaluated using 1) Beliefs about Medicines Questionnaire (BMQ)2, which examines beliefs around necessity of and concern with taking medications (high scores reflect strong beliefs) and 2) RA Self-Efficacy Questionnaire (RASE)3 (high scores reflect high self-efficacy). Physical factors were assessed using 1) multi-dimensional HAQ (MDHAQ)4 (high numbers indicate poor general health and worse symptoms) and 2) disease activity measured by the Composite Disease Activity Index (CDAI)5(high scores indicate high disease activity). Intraclass correlation coefficients (ICC) were used to evaluate test-retest reliability of CQR5 scores measured at baseline and 2 weeks. Bivariate correlations (Pearson’s r) were performed to determine relationships between psychosocial factors and medication adherence measured by CQR5 at baseline.
Results: 100 RA patients, [age, mean (SD) = 60.75(12.67) yrs], were recruited. In this sample, the CQR5 demonstrated excellent test-retest reliability (ICC=0.78). Adherence measured by CQR5 had a strong positive correlation with BMQ necessity scores (r = 0.64, p<0.001) and a weak negative correlation with BMQ concerns scores (r = -0.22, p<0.05). Correlations between the CQR5 and RASE, MDHAQ, and CDAI were negligible (r<0.17, p>0.05).
Conclusion: The CQR5 demonstrates excellent reliability over time. Adherence measured by the CQR5 is associated with beliefs about medicines, especially around the necessity of taking medications. A more in-depth investigation of the CQR5, including its validation against a gold standard for measuring medication adherence, is currently underway.
1) BMC Musculoskeletal Disorders. 2013; 14:286
2) Psychology & Health. 1999; 14: 1
3) Musculoskeletal Care. 2008; 49: 6
4) Best Practice & Research. Clinical Rheumatology. 2007; 21:755
5) Arthritis Research & Therapy. 2005; 7: R796
To cite this abstract in AMA style:Sweezie R, Bell MJ, Goldsmith C, Chiu I, Gutlin A, Sandhu S. Test-Retest Reliability of the 5-Item Compliance Questionnaire Rheumatology and Factors Influencing Its Assessment of Adherence in Patients with Rheumatoid Arthritis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/test-retest-reliability-of-the-5-item-compliance-questionnaire-rheumatology-and-factors-influencing-its-assessment-of-adherence-in-patients-with-rheumatoid-arthritis/. Accessed September 21, 2019.
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