Evidence map›Paper›PMID 31172365›Full record

ArticleClinical rheumatology2019

Qualitative assessment of medication adherence in patients with rheumatic diseases on biologic therapy.

Sudha Raghunath, Raif Hijjawi, Elizabeth Hoon, E Michael Shanahan, Fiona Goldblatt

Registry-linked trialAbstract read
PubMed Publisher
In one paragraph

Article in Clinical rheumatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04985435 (Better After CHoosing. Randomly Allocated or Patient Preference Based Treatment With Filgotinib or TNFi in Patients With Active Rheumatoid Arthritis), which is not on this map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT04985435 phase4recruitingnot on this mapstarted 2021, after this paper: background citation

Better After CHoosing. Randomly Allocated or Patient Preference Based Treatment With Filgotinib or TNFi in Patients With Active Rheumatoid Arthritis (BACH)

TypeinterventionalSponsorR.BosRan2021 to 2025Enrolled100ConditionsRheumatoid ArthritisArmsFilgotinib, Anti-Tumor Necrosis Factor Alpha Drug (Product), 50 patients will have a Free Choice between Filgotinib and anti TNF
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Trial
  4. Article
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Sudha RaghunathRheumatology Unit, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia. sudha.raghunath@monash.edu.ORCID http://orcid.org/0000-0002-3062-7328
Raif HijjawiFlinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia.
Elizabeth HoonUniversity of Adelaide, Adelaide, Australia.
E Michael ShanahanRheumatology Unit, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia.
Fiona GoldblattRheumatology Unit, Flinders Medical Centre, Southern Adelaide Local Health Network, Adelaide, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

INTRODUCTION/

objectivesDespite close management in specialized clinics, medication adherence remains a significant problem for some patients. The study aims to explore factors affecting medication adherence in patients attending a biologics clinic.

methodParticipants completed surveys including the Compliance Questionnaire Rheumatology (CQR) to quantify adherence rates. Purposive sampling targeting poorly adherent patients was used to select individuals for qualitative evaluation. Semi-structured interviews were performed and continued until saturation was achieved. Interviews were transcribed and coded using NVivo. Principles of grounded theory were used for data analysis.

resultsA total of 123 patients completed the survey (72 RA, 33 PsA, 18 AS). Of which, 96 patients completed all CQR items, of these 72% were identified as adequately adherent. A major theme which emerged from patient interviews was that the presence of active symptoms significantly influenced adherence. Patients tended not to prioritize medication taking until they had a recurrence of symptoms. Despite describing biologics as "life-changing", patients expressed concern regarding potential long-term side effects of these medications which affected adherence. Patients identified their relationship with their rheumatologist as pivotal and perceived diet, exercise and stress as critical. Intentional factors were the predominant drivers for non-adherence; patients made a risk-benefit analysis based on their beliefs and chose to not take their medications as prescribed.

conclusionsMedication adherence to traditional and biological therapies was lower than expected by treating clinicians in this patient group, who are closely supported in a dedicated biologics clinic. Several of the identified themes suggest that shared decision making and enhancing patient education may improve adherence in this group. Key Points • Adherence rates are suboptimal even in supported, educated, English-speaking patients in the biologics era. • Contributing factors were 'intentional' as patients chose to be non-adherent based on their beliefs. • Emergent themes suggest that enhancing patient education could improve adherence.

Indexed as

Medication AdherenceAdultAgedAged, 80 and overAntirheumatic AgentsArthritis, PsoriaticArthritis, RheumatoidBiological ProductsFemaleHumansMaleMiddle AgedQualitative ResearchRheumatic DiseasesSpondylitis, AnkylosingSurveys and QuestionnairesAntirheumatic AgentsBiological ProductsAdherence/complianceAnkylosing spondylitisBiologicsPsoriatic arthritisQualitativeRheumatoid arthritis

Identifiers

PMID31172365

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.