Ayano Kelly1,2,3, Kathleen Tymms1,2,4, Maarten de Wit5, Susan J Bartlett6,7, Marita Cross8, Therese Dawson9,10, Mary De Vera11,12, Vicki Evans13,14, Michael Gill15, Geraldine Hassett16,17, Irwin Lim18, Karine Manera3,19, Gabor Major20,21, Lyn March8,22,23, Sean O'Neill16,17, Marieke Scholte-Voshaar24, Premarani Sinnathurai8,22,23, Daniel Sumpton3,19,25, Armando Teixeira-Pinto3,19, Peter Tugwell26, Bart van den Bemt27,28, Allison Tong3,19. 1. College of Health and Medicine, Australian National University, Canberra, ACT, Australia. 2. Canberra Rheumatology, Canberra, ACT, Australia. 3. Centre for Kidney Research, The Children's Hospital at Westmead, Sydney, NSW, Australia. 4. Department of Rheumatology, Canberra Hospital, Canberra, ACT, Australia. 5. Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands. 6. Department of Medicine, McGill University, Montreal, Canada. 7. Division of Rheumatology, Johns Hopkins School of Medicine, Baltimore, Maryland, USA. 8. Institute of Bone and Joint Research, Kolling Institute of Medical Research, Sydney, NSW, Australia. 9. Lord Street Specialist Centre, Port Macquarie, NSW, Australia. 10. Mayo Hospital Specialist Centre, Taree, NSW, Australia. 11. Faculty of Pharmaceutical Sciences, The University of British Columbia, Vancouver, British Columbia, Canada. 12. Arthritis Research Canada, Richmond, British Columbia, Canada. 13. Clear Vision Consulting, OMERACT Patient Research Partner, Canberra, ACT, Australia. 14. Discipline of Optometry, University of Canberra, Canberra, ACT, Australia. 15. Dragon Claw, OMERACT Patient Research Partner, Sydney, NSW, Australia. 16. Department of Rheumatology, Liverpool Hospital, Sydney, NSW, Australia. 17. Ingham Institute of Applied Medical Research, Sydney, NSW, Australia. 18. BJC Health, Sydney, NSW, Australia. 19. Sydney School of Public Health, The University of Sydney, Sydney, NSW, Australia. 20. Bone and Joint Centre, John Hunter Hospital, Newcastle, NSW, Australia. 21. University of Newcastle, Faculty of Health and medicine, Newcastle, NSW, Australia. 22. Department of Rheumatology, Royal North Shore Hospital, Sydney, NSW, Australia. 23. Northern Clinical School, Sydney University, Sydney, NSW, Australia. 24. University of Twente, Department of Psychology, Health and Technology, OMERACT Patient Research Partner, Enschede, The Netherlands. 25. Department of Rheumatology, Concord Hospital, Sydney, NSW, Australia. 26. Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada. 27. Department of Pharmacy, Sint Maartenskliniek, Ubbergen, Netherlands. 28. Radboud University Medical Centre, Nijmegen, Netherlands.
Abstract
OBJECTIVES: This study aimed to identify and prioritize factors important to patients and caregivers with regard to medication adherence in gout, osteoporosis (OP) and rheumatoid arthritis (RA), and to describe the reasons for their decisions. METHODS: Patients with gout, OP and RA, and their caregivers purposively sampled from five rheumatology clinics in Australia, identified and ranked factors considered important for medication adherence using nominal group technique and discussed their decisions. An importance score (scale 0-1) was calculated, and qualitative data were analysed thematically. RESULTS: From 14 focus groups, 82 participants (67 patients, 15 caregivers) identified 49 factors. The top five factors based on the ranking of all participants were trust in doctor (importance score 0.46), medication effectiveness (0.31), doctor's knowledge (0.25), side effects (0.23), medication taking routine (0.13). The order of the ranking varied by participant groupings with patients ranking trust in doctor the highest whilst caregivers ranked side effects the highest. Five themes reflecting the reasons for factors influencing adherence were: motivation and certainty in supportive individualised care; living well and restoring function; fear of toxicity and cumulative harm; seeking control and involvement; and unnecessarily difficult and inaccessible. CONCLUSIONS: Factors related to the doctor, medication properties and patients' medication knowledge and routine were important for adherence. Strengthening doctor-patient trust and partnership, managing side effects, and empowering patients with knowledge and skills for medicine-taking could enhance medication adherence in patients with rheumatic conditions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
OBJECTIVES: This study aimed to identify and prioritize factors important to patients and caregivers with regard to medication adherence in gout, osteoporosis (OP) and rheumatoid arthritis (RA), and to describe the reasons for their decisions. METHODS:Patients with gout, OP and RA, and their caregivers purposively sampled from five rheumatology clinics in Australia, identified and ranked factors considered important for medication adherence using nominal group technique and discussed their decisions. An importance score (scale 0-1) was calculated, and qualitative data were analysed thematically. RESULTS: From 14 focus groups, 82 participants (67 patients, 15 caregivers) identified 49 factors. The top five factors based on the ranking of all participants were trust in doctor (importance score 0.46), medication effectiveness (0.31), doctor's knowledge (0.25), side effects (0.23), medication taking routine (0.13). The order of the ranking varied by participant groupings with patients ranking trust in doctor the highest whilst caregivers ranked side effects the highest. Five themes reflecting the reasons for factors influencing adherence were: motivation and certainty in supportive individualised care; living well and restoring function; fear of toxicity and cumulative harm; seeking control and involvement; and unnecessarily difficult and inaccessible. CONCLUSIONS: Factors related to the doctor, medication properties and patients' medication knowledge and routine were important for adherence. Strengthening doctor-patient trust and partnership, managing side effects, and empowering patients with knowledge and skills for medicine-taking could enhance medication adherence in patients with rheumatic conditions. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
Authors: M J H Voshaar; J E Vriezekolk; A M van Dulmen; B J F van den Bemt; M A F J van de Laar Journal: BMC Musculoskelet Disord Date: 2021-01-06 Impact factor: 2.362
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