Korean J Intern Med.  2018 Jan;33(1):203-210. 10.3904/kjim.2015.383.

Medication nonadherence in Korean patients with rheumatoid arthritis: the importance of belief about medication and illness perception

• Suh YS
• Cheon YH
• Kim HO
• Kim RB
• Park KS
• Kim SH
• Lee SG
• Park EK
• Hur J
• Lee SI

• KMID: 2411525
• DOI: http://doi.org/10.3904/kjim.2015.383

Abstract

BACKGROUND/AIMS
To investigate medication nonadherence in Korean patients with rheumatoid arthritis (RA) and analyze related factors.
METHODS
A total of 292 patients with RA participated in this study. Medication nonadherence, intentional or unintentional, was gauged via self-reported questionnaire. Patient perceptions of illness, treatment beliefs, and moods were measured via Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, and Patient Health Questionnaire-2, respectively. Demographic and clinical data were also collected. Multinomial regression analysis was used to assess the impact of demographic, clinical, and psychological factors on medication nonadherence.
RESULTS
The medication nonadherence rate was 54.1% (intentional, 21.6%; unintentional, 32.5%). Intentional nonadherence was reported most often in patients treated daily drugs (nonsteroidal anti-inflammatory drugs and/or disease-modifying antirheumatic drugs) (24.2%), and unintentional nonadherence was highest in patients receiving methotrexate (33.3%) (p = 0.872). In univariate analysis, beliefs in necessity and concerns of medication differed significantly in adherent and nonadherent patients (intentional or unintentional). When controlling for other factors that may impact medication nonadherence, less belief in necessity of medication (odds ratio [OR], 0.81; 95% confidence interval [CI], 0.68 to 0.95) and greater emotional response to disease (OR, 1.19; 95% CI, 1.01 to 1.40) were important predictors of intentional nonadherence.
CONCLUSIONS
Medication nonadherence is common in Korean patients with RA. Less belief in necessity of medication and greater emotional response to disease were identified as key factors prompting intentional nonadherence. These factors may be strategically targeted to improve medication adherence rates and subsequent clinical outcomes.

Keyword

Arthritis, rheumatoid; Medication adherence; Antirheumatic agents

MeSH Terms

Antirheumatic Agents
Arthritis, Rheumatoid*
Humans
Medication Adherence*
Methotrexate
Psychology
Antirheumatic Agents
Methotrexate