Observational studyThe Journal of rheumatology2014
Inconsistent treatment with disease-modifying antirheumatic drugs: a longitudinal data analysis.
Abstract readObservational Study
In one paragraph
Observational study in The Journal of rheumatology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
–field-weighted citation impact
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A systematic review of the barriers affecting medication adherence in patients with rheumatic diseases.Rheumatology international · 2017Pooled it
- Rate and causes of noncompliance with disease-modifying antirheumatic drug regimens in patients with rheumatoid arthritis.Clinical rheumatology · 2021Article
- Predictors of patient decision to discontinue anti-rheumatic medication in patients with rheumatoid arthritis: results from the Ontario best practices research initiative.Clinical rheumatology · 2017Article
- Challenges of developing a cardiovascular risk calculator for patients with rheumatoid arthritis.PloS one · 2017Article
- Does non-adherence to DMARDs influence hospital-related healthcare costs for early arthritis in the first year of treatment?PloS one · 2017Article
- Medication adherence in patients with rheumatoid arthritis: why do patients not take what we prescribe?Rheumatology international · 2016Review
- Patient Preferences Regarding Rheumatoid Arthritis Therapies: A Conjoint Analysis.American health & drug benefits · 2016Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Maria D MjaavattenFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital. maria_mjaavatten@hotmail.com.
Helga RadnerFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Kazuki YoshidaFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Nancy A ShadickFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Michelle L FritsFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Christine K IannacconeFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Tore K KvienFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Michael E WeinblattFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Daniel H SolomonFrom the Division of Rheumatology, Immunology and Allergy, and the Division of Pharmacoepidemiology, Brigham and Women's Hospital, Boston, Massachusetts, USA; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna, Vienna, Austria; Department of Rheumatology, Kameda Medical Center, Kamogawa, Chiba Prefecture, Japan.M.D. Mjaavatten, MD, PhD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Diakonhjemmet Hospital; H. Radner, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Internal Medicine III, Division of Rheumatology, Medical University Vienna; K. Yoshida, MD, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, and Department of Rheumatology, Kameda Medical Center; N.A. Shadick, MD, MPH; M.L. Frits, BA; C.K. Iannaccone, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; T.K. Kvien, MD, PhD, Department of Rheumatology, Diakonhjemmet Hospital; M.E. Weinblatt, MD, MPH, Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital; D.H. Solomon, MD, MPH, Division of Rheumatology, and Immunology and Allergy, and Division of Pharmacoepidemiology, Brigham and Women's Hospital.
Funding
Patient Centered Outcomes Research in RheumatologyK24AR055989 · NIAMS · BRIGHAM AND WOMEN'S HOSPITAL · PI SOLOMON, DANIEL HAL · 2008 to 2017
$1.5MNIAMS NIH HHS K24 AR055989
Abstract
objectiveCurrent recommendations advocate treatment with disease-modifying antirheumatic drugs (DMARD) in all patients with active rheumatoid arthritis (RA). We investigated the frequency of and reasons for inconsistent DMARD use among patients in a clinical rheumatology cohort.
methodsPatients in the Brigham Rheumatoid Arthritis Sequential Study were studied for DMARD use (any or none) at each semiannual study timepoint during the first 2 study years. Inconsistent use was defined as DMARD use at ≤ 40% of study timepoints. Characteristics were compared between inconsistent and consistent users (> 40%), and factors associated with inconsistent DMARD use were determined through multivariate logistic regression. A medical record review was performed to determine the reasons for inconsistent use.
resultsOf 848 patients with ≥ 4 out of 5 visits recorded, 55 (6.5%) were inconsistent DMARD users. Higher age, longer disease duration, and rheumatoid factor negativity were statistically significant correlates of inconsistent use in the multivariate analyses. The primary reasons for inconsistent use identified through chart review, allowing for up to 2 co-primary reasons, were inactive disease (n = 28, 50.9%), intolerance to DMARD (n = 18, 32.7%), patient preference (n = 7, 12.7%), comorbidity (n = 6, 10.9%), DMARD not being effective (n = 3, 5.5%), and pregnancy (n = 3, 5.5%). During subsequent followup, 14/45 (31.1%) inconsistent users with sufficient data became consistent users of DMARD.
conclusionA small proportion of patients with RA in a clinical rheumatology cohort were inconsistent DMARD users during the first 2 years of followup. While various patient factors correlate with inconsistent use, many patients re-start DMARD and become consistent users over time.
Indexed as
Medication AdherenceAdultAgedAge FactorsAntirheumatic AgentsArthritis, RheumatoidCohort StudiesFemaleFollow-Up StudiesHumansLogistic ModelsLongitudinal StudiesMaleMiddle AgedRetrospective StudiesRheumatoid FactorAntirheumatic AgentsRheumatoid FactorDISEASE-MODIFYING ANTIRHEUMATIC DRUGSDRUG ADHERENCELONGITUDINAL STUDIESRHEUMATOID ARTHRITIS
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