Relationship between beliefs about medicines, adherence to treatment, and disease activity in patients with rheumatoid arthritis under subcutaneous anti-TNFalpha therapy.
Horne, Rob; Albert, Adelin; Boone, Caroline
2018 • In Patient Preference and Adherence, 12, p. 1099-1111
[en] Objective: In patients with rheumatoid arthritis (RA), nonadherence to treatment is often related to patients' beliefs and concerns regarding their medication. This study aimed to analyze the correlations regarding patients' medication beliefs, medication adherence, and objective measures of disease activity and safety in patients with RA established on subcutaneous (SC) anti-tumor necrosis factor alpha (TNFalpha) therapy. Methods: This Phase IV, noninterventional, non-drug-specific study enrolled patients with RA being treated with stable-dose SC anti-TNFalpha (adalimumab, etanercept, golimumab, and certolizumab pegol). At initial visit and 6 and 12 months later, patients completed the Beliefs about Medicines Questionnaire-Specific section, assessing perceptions of personal need for anti-TNFalpha therapy (anti-TNFalpha-Necessity) and concerns (anti-TNFalpha-Concerns), Medication Adherence Rating Scale (MARS), mean Disease Activity Score in 28 joints (DAS28), and other scales. Longitudinal data were analyzed by linear mixed models. Results: A total of 460 patients were included. At initial visit, anti-TNFalpha-Necessity beliefs were high (mean +/- SD: 4.3 +/- 0.55) vs anti-TNFalpha-Concerns (2.8 +/- 0.78). Medication adherence (MARS) was high (4.8 +/- 0.39). All scores remained stable over the 1-year follow-up period. Anti-TNFalpha-Necessity beliefs and anti-TNFalpha-Concerns were not related to each other, but strongly correlated with medication adherence. While concerns worsened with disease activity, clinical status, and low quality of life, necessity beliefs remained unaffected. Conclusion: In patients with RA established on stable-dose SC anti-TNFalpha, anti-TNFalpha-Necessity beliefs persistently outweighed anti-TNFalpha-Concerns, but both correlated with adherence. These findings may be of use in subsequent studies looking to predict adherence in patients starting treatment with SC anti-TNFalpha.
Disciplines :
Rheumatology
Author, co-author :
Horne, Rob; University College London School of Pharmacy, London, UK
Albert, Adelin ; Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
Boone, Caroline; PFIZER SA/NV > Medical
Language :
English
Title :
Relationship between beliefs about medicines, adherence to treatment, and disease activity in patients with rheumatoid arthritis under subcutaneous anti-TNFalpha therapy.
Cross M, Smith E, Hoy D, et al. The global burden of rheumatoid arthritis: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(7):1316–1322.
Kumar P, Banik S. Pharmacotherapy options in rheumatoid arthritis. Clin Med Insights Arthritis Musculoskelet Disord. 2013;6:35–43.
Scott DL. Biologics-based therapy for the treatment of rheumatoid arthritis. Clin Pharmacol Ther. 2012;91(1):30–43.
Gibofsky A. Comparative effectiveness of current treatments for rheumatoid arthritis. Am J Manag Care. 2012;18(13 Suppl):S303–S314.
Radner H, Aletaha D. Anti-TNF in rheumatoid arthritis: an overview. Wien Med Wochenschr. 2015;165(1–2):3–9.
Combe B, Landewe R, Lukas C, et al. EULAR recommendations for the management of early arthritis: report of a task force of the European Standing Committee for International Clinical Studies Including Therapeutics (ESCISIT). Ann Rheum Dis. 2007;66(1):34–45.
American College of Rheumatology Subcommittee on Rheumatoid Arthritis Guidelines. Guidelines for the management of rheumatoid arthritis: 2002 update. Arthritis Rheum. 2002;46(2):328–346.
World Heath Organization. Adherence to Long-Term Therapies: Evidence for Action. Geneva: WHO; 2003. Available from: http://www.who.int/chp/knowledge/publications/adherence:full_report.pdf. Accessed July 21, 2017.
Joplin S, van der Zwan R, Joshua F, Wong PK. Medication adherence in patients with rheumatoid arthritis: the effect of patient education, health literacy, and musculoskeletal ultrasound. Biomed Res Int. 2015;2015:150658.
Horne R, Weinman J. Patients’ beliefs about prescribed medicines and their role in adherence to treatment in chronic physical illness: processes and applications. J Psychosom Res. 1999;47(6):555–567.
Horne R, Chapman SC, Parham R, Freemantle N, Forbes A, Cooper V. Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the necessity-concerns framework. PLoS One. 2013;8(12):e80633.
Neame R, Hammond A. Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology. 2005;44(6): 762–767.
Morgan C, McBeth J, Cordingley L, et al. The influence of behavioural and psychological factors on medication adherence over time in rheumatoid arthritis patients: a study in the biologics era. Rheumatology (Oxford). 2015;54(10):1780–1791.
Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: the development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health. 1999;14(1):1–24.
Thompson K, Kulkarni J, Sergejew AA. Reliability and validity of a new Medication Adherence Rating Scale (MARS) for the psychoses. Schizophr Res. 2000;42(3):241–247.
Prevoo ML, van’t Hof MA, Kuper HH, van Leeuwen MA, van de Putte LB, van Riel PL. Modified disease activity scores that include twenty-eight-joint counts: development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum. 1995;38(1):44–48.
Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis Rheum. 1980;23(2):137–145.
Jensen MP, Karoly P. Self-report scales and procedures for assessing pain in adults. In: Turk DC, Melzack R, editors. Handbook of Pain Assessment. New York: Guilford Press; 1992:134–151.
Shahid A, Wilkinson K, Marcu S, Shapiro CM. Visual analogue scale to evaluate fatigue severity (VAS-F). In: Shahid A, Wilkinson K, Marcu S, Shapiro C, editors. STOP, THAT, and One Hundred Other Sleep Scales. Heidelberg: Springer; 2011:399–402.
EuroQol Group. EuroQol – a new facility for the measurement of health-related quality of life. Health Policy. 1990;16(3):199–208.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9. J Gen Intern Med. 2001;16(9):606–613.
Treharne GJ, Lyons AC, Kitas GD. Medication adherence in rheumatoid arthritis: effects of psychosocial factors. Psychol Health Med. 2004;9(3):337–349.
van den Bemt BJ, van den Hoogen FH, Benraad B, Hekster YA, van Riel PL, van Lankveld W. Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease modifying antirheumatic drugs. J Rheumatol. 2009;36(10):2164–2170.
de Thurah A, Nørgaard M, Harder I, Stengaard-Pedersen K. Compliance with methotrexate treatment in patients with rheumatoid arthritis: influence of patients’ beliefs about the medicine. A prospective cohort study. Rheumatol Int. 2010;30(11):1441–1448.
Hope HF, Bluett J, Barton A, Hyrich KL, Cordingley L, Verstappen SM. Psychological factors predict adherence to methotrexate in rheumatoid arthritis; findings from a systematic review of rates, predictors and associations with patient-reported and clinical outcomes. RMD Open. 2016;2(1):e000171.
Nicklas LB, Dunbar M, Wild M. Adherence to pharmacological treatment of non-malignant chronic pain: the role of illness perceptions and medication beliefs. Psychol Health. 2010;25(5):601–615.
Phatak HM, Thomas J. Relationships between beliefs about medications and nonadherence to prescribed chronic medications. Ann Pharmacother. 2006;40(10):1737–1742.
Gonzalez JS, Penedo FJ, Llabre MM, et al. Physical symptoms, beliefs about medications, negative mood, and long-term HIV medication adherence. Ann Behav Med. 2007;34(1):46–55.
Horne R, Cooper V, Gellaitry G, Date HL, Fisher M. Patients’ perceptions of highly active antiretroviral therapy in relation to treatment uptake and adherence: the utility of the necessity-concerns framework. J Acquir Immune Defic Syndr. 2007;45(3):334–341.
Jamous RM, Sweileh WM, El-Deen Abu Taha AS, Zyoud SH. Beliefs about medicines and self-reported adherence among patients with chronic illness: a study in Palestine. J Family Med Prim Care. 2014;3(3): 224–229.
Nestoriuc Y, Orav EJ, Liang MH, Horne R, Barsky AJ. Prediction of nonspecific side effects in rheumatoid arthritis patients by beliefs about medicines. Arthritis Care Res (Hoboken). 2010;62(6):791–799.
Chapman SC, Horne R, Eade R, Balestrini S, Rush J, Sisodiya SM. Applying a perceptions and practicalities approach to understanding nonadherence to antiepileptic drugs. Epilepsia. 2015;56(9): 1398–1407.
Horne R, Weinman J. Self-regulation and self-management in asthma: exploring the role of illness perceptions and treatment beliefs in explaining non-adherence to preventer medication. Psychol Health. 2002; 17(1):17–32.
Horne R, Parham R, Driscoll R, Robinson A. Patients’ attitudes to medicines and adherence to maintenance treatment in inflammatory bowel disease. Inflamm Bowel Dis. 2009;15(6):837–844.
Clifford S, Barber N, Elliott R, Hartley E, Horne R. Patient-centred advice is effective in improving adherence to medicines. Pharm World Sci. 2006;28(3):165–170.
Petrie KJ, Perry K, Broadbent E, Weinman J. A text message programme designed to modify patients’ illness and treatment beliefs improves self-reported adherence to asthma preventer medication. Br J Health Psychol. 2012;17(1):74–84.
National Institute for Health and Care Excellence. Medicines Adherence: Involving Patients in Decisions about Prescribed Medicines and Supporting Adherence. London: NICE; 2009. Clinical guideline [CG76]. Available from: https://http://www.nice.org.uk/Guidance/CG76. Accessed July 21, 2017.
Stirratt MJ, Dunbar-Jacob J, Crane HM, et al. Self-report measures of medication adherence behavior: recommendations on optimal use. Transl Behav Med. 2015;5(4):470–482.
