Medication adherence and cost-related medication non-adherence in patients with rheumatoid arthritis

A cross-sectional study

Parvaneh Heidari, Wendy Cross, Carolina Weller, Mohammadali Nazarinia, Kimberley Crawford

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Aim: First, to assess the clinical characteristics and medication adherence to oral rheumatoid arthritis (RA) medications in patients with RA. Second, to examine adherence determinants with a focus on the effect of medication out-of-pocket (OOP) costs on medication adherence to oral RA medications. Lastly, to examine cost-related medication non-adherence (CRN) in patients with RA. Methods: A cross-sectional study of patients with RA was conducted at rheumatology outpatient clinics in Shiraz, Iran. The data collection survey consisted of 5 sections including demographic questions, disease-related questions, Compliance Questionnaire Rheumatology (CQR), CRN questions and an open-ended question. SPSS version 24 was used for analysis. Results: A total of 308 completed surveys were collected. Adherence to oral RA medications was 40.3%. Just under 20% of participants were biologic disease-modifying antirheumatic drugs (bDMARDs) users and these bDMARDs users were 0.82 times less likely to be adherent to their oral RA medications compared to non-bDMARDs users (P < 0.05). There was no statistically significant association between OOP costs and adherence to oral RA medications (P > 0.05). However, 28.7% of participants reported not refilling, delaying to refill, skipping doses or taking smaller doses due to cost. In findings of the open-ended question, medication costs and affordability were the most commonly mentioned barriers to medication adherence. Conclusion: Non-adherence to oral RA medications was prevalent among Iranian patients with RA and OOP costs were a barrier to medication adherence.

Original languageEnglish
Pages (from-to)555-566
Number of pages12
JournalInternational Journal of Rheumatic Diseases
Volume22
Issue number4
DOIs
Publication statusPublished - 1 Apr 2019

Keywords

  • medication adherence
  • medication non-adherence
  • out-of-pocket costs
  • out-of-pocket payments
  • rheumatoid arthritis

Cite this

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title = "Medication adherence and cost-related medication non-adherence in patients with rheumatoid arthritis: A cross-sectional study",
abstract = "Aim: First, to assess the clinical characteristics and medication adherence to oral rheumatoid arthritis (RA) medications in patients with RA. Second, to examine adherence determinants with a focus on the effect of medication out-of-pocket (OOP) costs on medication adherence to oral RA medications. Lastly, to examine cost-related medication non-adherence (CRN) in patients with RA. Methods: A cross-sectional study of patients with RA was conducted at rheumatology outpatient clinics in Shiraz, Iran. The data collection survey consisted of 5 sections including demographic questions, disease-related questions, Compliance Questionnaire Rheumatology (CQR), CRN questions and an open-ended question. SPSS version 24 was used for analysis. Results: A total of 308 completed surveys were collected. Adherence to oral RA medications was 40.3{\%}. Just under 20{\%} of participants were biologic disease-modifying antirheumatic drugs (bDMARDs) users and these bDMARDs users were 0.82 times less likely to be adherent to their oral RA medications compared to non-bDMARDs users (P < 0.05). There was no statistically significant association between OOP costs and adherence to oral RA medications (P > 0.05). However, 28.7{\%} of participants reported not refilling, delaying to refill, skipping doses or taking smaller doses due to cost. In findings of the open-ended question, medication costs and affordability were the most commonly mentioned barriers to medication adherence. Conclusion: Non-adherence to oral RA medications was prevalent among Iranian patients with RA and OOP costs were a barrier to medication adherence.",
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Medication adherence and cost-related medication non-adherence in patients with rheumatoid arthritis : A cross-sectional study. / Heidari, Parvaneh; Cross, Wendy; Weller, Carolina; Nazarinia, Mohammadali; Crawford, Kimberley.

In: International Journal of Rheumatic Diseases, Vol. 22, No. 4, 01.04.2019, p. 555-566.

Research output: Contribution to journalArticleResearchpeer-review

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T1 - Medication adherence and cost-related medication non-adherence in patients with rheumatoid arthritis

T2 - A cross-sectional study

AU - Heidari, Parvaneh

AU - Cross, Wendy

AU - Weller, Carolina

AU - Nazarinia, Mohammadali

AU - Crawford, Kimberley

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N2 - Aim: First, to assess the clinical characteristics and medication adherence to oral rheumatoid arthritis (RA) medications in patients with RA. Second, to examine adherence determinants with a focus on the effect of medication out-of-pocket (OOP) costs on medication adherence to oral RA medications. Lastly, to examine cost-related medication non-adherence (CRN) in patients with RA. Methods: A cross-sectional study of patients with RA was conducted at rheumatology outpatient clinics in Shiraz, Iran. The data collection survey consisted of 5 sections including demographic questions, disease-related questions, Compliance Questionnaire Rheumatology (CQR), CRN questions and an open-ended question. SPSS version 24 was used for analysis. Results: A total of 308 completed surveys were collected. Adherence to oral RA medications was 40.3%. Just under 20% of participants were biologic disease-modifying antirheumatic drugs (bDMARDs) users and these bDMARDs users were 0.82 times less likely to be adherent to their oral RA medications compared to non-bDMARDs users (P < 0.05). There was no statistically significant association between OOP costs and adherence to oral RA medications (P > 0.05). However, 28.7% of participants reported not refilling, delaying to refill, skipping doses or taking smaller doses due to cost. In findings of the open-ended question, medication costs and affordability were the most commonly mentioned barriers to medication adherence. Conclusion: Non-adherence to oral RA medications was prevalent among Iranian patients with RA and OOP costs were a barrier to medication adherence.

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KW - medication adherence

KW - medication non-adherence

KW - out-of-pocket costs

KW - out-of-pocket payments

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