ArticlePloS one2018
Use of rheumatology-specific patient navigators to understand and reduce barriers to medication adherence: Analysis of qualitative findings.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Patient navigation programmes for symptomatic lung cancer patients: a scoping review.Archives of public health = Archives belges de sante publique · 2025Pooled it
- The Care-coordination Approach to Learning Lupus Self-Management: a patient navigator intervention for systemic lupus inpatients.Lupus science & medicine · 2021Trial
- Sex-based differences in bDMARD initiation and persistence in spondyloarthritis: a 17-year follow-up study from the REGISPON-3 registry.Rheumatology (Oxford, England) · 2026Observational
- Talking About Barriers to Disease-Modifying Anti-Rheumatic Drugs: Content Analysis of Audio-Recorded Routine Clinical Visits of Patients with Rheumatoid Arthritis.Patient preference and adherence · 2025Article
- A patient-centered evaluation of a novel medical student-based patient navigation program.Patient education and counseling · 2024Article
- Similar values, different expectations: How do patients and providers view 'health' and perceive the healthcare experience?Health expectations : an international journal of public participation in health care and health policy · 2022Article
- The Impact of an Integrated Care Management Program on Acute Care Use and Outpatient Appointment Attendance Among High-Risk Patients With Lupus.ACR open rheumatology · 2022Article
- How Can We Enhance Adherence to Medications in Patients with Systemic Lupus Erythematosus? Results from a Qualitative Study.Journal of clinical medicine · 2022Article
- Article
- Sustained long-term benefits of patient support program participation in immune-mediated diseases: improved medication-taking behavior and lower risk of a hospital visit.Journal of managed care & specialty pharmacy · 2021Article
- Arthritis liaison: a First Nations community-based patient care facilitator.Health promotion and chronic disease prevention in Canada : research, policy and practice · 2021Article
- Use of an Integrated Care Management Program to Uncover and Address Social Determinants of Health for Individuals With Lupus.ACR open rheumatology · 2021Article
Corrections and comments
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Authors and funding
7 authors.
Funding
Abstract
objectiveAdherence to medications among patients with rheumatic diseases is often suboptimal. Patient navigators, individuals trained in care coordination, motivational interviewing and basic rheumatology and pharmacology, have not been employed to explore and address this issue. We piloted a single-site, single arm intervention to determine the feasibility and acceptability of using rheumatology-specific navigators to understand and reduce barriers to adherence to oral disease modifying anti-rheumatic drugs (DMARDs). We analyzed our qualitative findings from navigator-patient interactions as well as patient satisfaction with the intervention.
methodsWe recruited patients ≥18 years with a systemic rheumatic disease who initiated an oral DMARD within the prior 6 months. Navigators conducted baseline needs assessments and 2-4 week follow-up calls to understand and address issues related to medication adherence. We analyzed patient-navigator encounters qualitatively using content analysis to identify key themes related to barriers to adherence and navigator actions performed in response to the barriers described. We also categorized intentional and unintentional nonadherent behavior and assessed satisfaction with the navigator experience (range 0-5, 5 = most satisfied).
results107 rheumatology patients were followed for up to 6 months. Mean patient age was 55 years (+17) and 93% were female; 36% described one or more episode of intentional or unintentional nonadherence. The three most common themes identified as barriers to adherence were fear of adverse events (raised by 54%), concerns about medication effectiveness (43%), and challenges with medication acquisition (32%). 86% of participants described at least one adherence-related barrier. Frequent navigator actions included facilitation of patient-doctor communication (38%), medication and diagnosis education (27%), and development of individualized strategies to improve adherence (16%). Patients were satisfied with the navigator experience (mean 4.4 + 0.9).
conclusionNavigators uncovered and addressed a number of medication adherence-related concerns and patients were satisfied with the services provided.
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