ArticleBMJ open2015
Patients' adherence-related beliefs about methotrexate: a qualitative study of the role of written patient information.
Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 3 of them syntheses that pooled it.
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
19 citing papers in PubMed, 3 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- Receipt of Medicines Information From the Internet and Other Information Sources Among Adult Medicine Users in Developed Economies, 2010-2025: Systematic Review.Journal of medical Internet research · 2026Pooled it
- The information required by people with inflammatory arthritis when taking Methotrexate: a mixed-methods systematic review.Rheumatology (Oxford, England) · 2024Pooled it
- Patient Perspectives to Inform a Health Literacy Educational Program: A Systematic Review and Thematic Synthesis of Qualitative Studies.International journal of environmental research and public health · 2019Pooled it
- Perspectives of patients with rheumatoid arthritis towards the use of parenteral methotrexate: a qualitative study.International journal of clinical pharmacy · 2026Article
- Development of a Complex Biofeedback-Based Intervention to Improve Methotrexate Adherence in Rheumatoid Arthritis: A COM-B Model Informed Qualitative Study.Patient preference and adherence · 2026Article
- Methotrexate-related beliefs, fears, and use among patients with rheumatoid arthritis: a cross-sectional survey.Reumatologia · 2026Article
- Beliefs of Moroccan patients with chronic inflammatory rheumatic diseases regarding medication: related factors and correlation with therapeutic adherence.BMC rheumatology · 2024Article
- Perspective and Experience of Patients with Aplastic Anemia on Medication Adherence.Patient preference and adherence · 2023Article
- Adverse events during short- and long-term exposure to low-dose weekly methotrexate for rheumatic diseases.Rheumatology advances in practice · 2023Article
- Rates and predictors of methotrexate-related adverse events in patients with early rheumatoid arthritis: results from a nationwide UK study.Rheumatology (Oxford, England) · 2022Article
- Developing a framework for understanding health information behavior change from avoidance to acquisition: a grounded theory exploration.BMC public health · 2022Article
- Attitudes of Australians with inflammatory arthritis to biologic therapy and biosimilars.Rheumatology advances in practice · 2022Article
- Fatigue in Systemic Lupus Erythematosus and Rheumatoid Arthritis: A Comparison of Mechanisms, Measures and Management.Journal of clinical medicine · 2021Review
- Factors Contributing to Medication Adherence in Patients with a Chronic Condition: A Scoping Review of Qualitative Research.Pharmaceutics · 2021Article
- Opt-in or opt-out health-care communication? A cross-sectional study.Health expectations : an international journal of public participation in health care and health policy · 2021Article
- Rheumatoid Arthritis Patients' Motivations for Accepting or Resisting Disease-Modifying Antirheumatic Drug Treatment Regimens.Arthritis care & research · 2018Article
- Patient and Physician Perceptions of Drug Safety Information for Sleep Aids: A Qualitative Study.Drug safety · 2017Article
- Medication Risk Communication in Rheumatology: Where Are We and Where Do We Go from Here?Current rheumatology reports · 2017Review
- Concerns of patients with systemic lupus erythematosus and adherence to therapy - a qualitative study.Patient preference and adherence · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMethotrexate is effective in treating inflammatory arthritis, but both underadherence and overadherence can put patients at risk. Patients may fail to adhere due to practicalities including the unusual weekly dosing regimen, but medication beliefs also play a role. This study explored how both beliefs about necessity and concerns about methotrexate become established in patients with inflammatory arthritis and how patients use information in managing their beliefs and concerns.
designSemistructured interviews were conducted with patients taking oral methotrexate for inflammatory arthritis. Interviews were transcribed verbatim and analysed thematically.
settingParticipants were recruited from a single Trust in the East Midlands.
participantsFifteen patients (4 male, 11 female) with inflammatory arthritis.
resultsMethotrexate was commonly prescribed at the time of diagnosis; at this point, experience of illness was influential for beliefs about medication necessity. Following prescription, patients absorbed information from written and verbal sources which reinforced beliefs about necessity but also raised concerns, including fear of side effects. Over time, beliefs were modified on the basis of personal experience, particularly of medication effectiveness and side effects. Some patients described tensions and dissonance in their beliefs and experiences of methotrexate, which put them at risk of non-adherence. Patients used information-seeking and information-avoidance as strategies to resolve these tensions. The available information did little to help suppress dissonance and sometimes exacerbated it.
conclusionsPatients' experiences of coming to terms with taking methotrexate are complex, and their experiences of dissonance are particularly problematic. Experiences might be improved by supporting patients to assess necessity (particularly in the presence of side effects) and by providing information to moderate unnecessary concerns. Improving recording and sharing of monitoring results may be one way to meet these needs.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.