M J H Voshaar1, J E Vriezekolk2, A M van Dulmen3,4,5, B J F van den Bemt6,7,8, M A F J van de Laar9. 1. Department Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. m.j.h.voshaar@utwente.nl. 2. Department of Rheumatology, Sint Maartenskliniek, Nijmegen, The Netherlands. 3. Nivel (Netherlands Institute for Health Services Research), Utrecht, The Netherlands. 4. Department of Primary and Community Care, Radboud University Medical Centre, Radboud Institute for Health Sciences, Nijmegen, The Netherlands. 5. Faculty of Health and Social Sciences, University of South- Eastern Norway, Drammen, Norway. 6. Department of Pharmacy, Sint Maartenskliniek, Nijmegen, The Netherlands. 7. Department of Pharmacy, RadboudUMC, Nijmegen, The Netherlands. 8. Department of Clinical Pharmacy and Toxicology, Maastricht University Medical Centre, Maastricht, The Netherlands. 9. Arthritis Centre Twente, Medisch Spectrum Twente & University of Twente, P.O box 50,000, 7500, KA, Enschede, The Netherlands.
Abstract
INTRODUCTION: Facilitators and barriers of adherence to disease-modifying anti-rheumatic drugs (DMARDs) have been identified by patients with inflammatory arthritis earlier. However, the relative importance from the patients' perspective of these factors is unknown. Knowledge on this ranking might guide the development of interventions and may facilitate targeted communication on adherence. This study aims to examine 1) the relative importance patients attach to facilitators and barriers for DMARDs adherence, and 2) the relationship between patient characteristics and ranking of these factors. METHODS: One hundred twenty-eight outpatients with inflammatory arthritis; (60% female, mean age 62 years (SD = 12), median disease duration 15 years, IQR (7, 23) participated in a Maximum Difference scaling exercise and ranked 35 items based upon previously identified facilitators and barriers to medication adherence. Hierarchical Bayes estimation was used to compute mean Rescaled Probability Scores (RPS; 0-100) (i.e. relative importance score). Kendall's coefficient of concordance was used to examine a possible association between patients' characteristics (i.e. age, sex and educational level) and ranking of the items. RESULTS: The three most important items ranked by patients were: Reduction of symptoms formulated as "Arthritis medications help to reduce my symptoms" (RPS = 7.30, CI 7.17-7.44), maintaining independence formulated as "I can maintain my independence as much as possible" (RPS = 6.76, CI 6.54-6.97) and Shared decision making formulated as "I can decide -together with my physician- about my arthritis medications" (RPS = 6.48, CI 6.24-6.72). No associations between patient characteristics and ranking of factors were found. CONCLUSIONS: Reducing symptoms, maintaining independency and shared decision making are patients' most important factors for DMARDs adherence. This knowledge might guide the development of interventions and may facilitate communication between health professionals and their patients on medication adherence.
INTRODUCTION: Facilitators and barriers of adherence to disease-modifying anti-rheumatic drugs (DMARDs) have been identified by patients with inflammatory arthritis earlier. However, the relative importance from the patients' perspective of these factors is unknown. Knowledge on this ranking might guide the development of interventions and may facilitate targeted communication on adherence. This study aims to examine 1) the relative importance patients attach to facilitators and barriers for DMARDs adherence, and 2) the relationship between patient characteristics and ranking of these factors. METHODS: One hundred twenty-eight outpatients with inflammatory arthritis; (60% female, mean age 62 years (SD = 12), median disease duration 15 years, IQR (7, 23) participated in a Maximum Difference scaling exercise and ranked 35 items based upon previously identified facilitators and barriers to medication adherence. Hierarchical Bayes estimation was used to compute mean Rescaled Probability Scores (RPS; 0-100) (i.e. relative importance score). Kendall's coefficient of concordance was used to examine a possible association between patients' characteristics (i.e. age, sex and educational level) and ranking of the items. RESULTS: The three most important items ranked by patients were: Reduction of symptoms formulated as "Arthritis medications help to reduce my symptoms" (RPS = 7.30, CI 7.17-7.44), maintaining independence formulated as "I can maintain my independence as much as possible" (RPS = 6.76, CI 6.54-6.97) and Shared decision making formulated as "I can decide -together with my physician- about my arthritis medications" (RPS = 6.48, CI 6.24-6.72). No associations between patient characteristics and ranking of factors were found. CONCLUSIONS: Reducing symptoms, maintaining independency and shared decision making are patients' most important factors for DMARDs adherence. This knowledge might guide the development of interventions and may facilitate communication between health professionals and their patients on medication adherence.
Authors: Ana Palacio; Desiree Garay; Benjamin Langer; Janielle Taylor; Barbara A Wood; Leonardo Tamariz Journal: J Gen Intern Med Date: 2016-05-09 Impact factor: 5.128
Authors: L T C van Hulst; W Kievit; R van Bommel; P L C M van Riel; L Fraenkel Journal: Arthritis Care Res (Hoboken) Date: 2011-10 Impact factor: 4.794
Authors: Ayano Kelly; Kathleen Tymms; Maarten de Wit; Susan J Bartlett; Marita Cross; Therese Dawson; Mary De Vera; Vicki Evans; Michael Gill; Geraldine Hassett; Irwin Lim; Karine Manera; Gabor Major; Lyn March; Sean O'Neill; Marieke Scholte-Voshaar; Premarani Sinnathurai; Daniel Sumpton; Armando Teixeira-Pinto; Peter Tugwell; Bart van den Bemt; Allison Tong Journal: Arthritis Care Res (Hoboken) Date: 2019-07-19 Impact factor: 4.794
Authors: Holly F Hope; Kimme L Hyrich; James Anderson; James Bluett; Jamie C Sergeant; Anne Barton; Lis Cordingley; Suzanne M M Verstappen Journal: Rheumatology (Oxford) Date: 2020-01-01 Impact factor: 7.580
Authors: Bart J F van den Bemt; Frank H J van den Hoogen; Bart Benraad; Yechiel A Hekster; Piet L C M van Riel; Wim van Lankveld Journal: J Rheumatol Date: 2009-09-01 Impact factor: 4.666
Authors: Josef S Smolen; Robert Landewé; Johannes Bijlsma; Gerd Burmester; Katerina Chatzidionysiou; Maxime Dougados; Jackie Nam; Sofia Ramiro; Marieke Voshaar; Ronald van Vollenhoven; Daniel Aletaha; Martin Aringer; Maarten Boers; Chris D Buckley; Frank Buttgereit; Vivian Bykerk; Mario Cardiel; Bernard Combe; Maurizio Cutolo; Yvonne van Eijk-Hustings; Paul Emery; Axel Finckh; Cem Gabay; Juan Gomez-Reino; Laure Gossec; Jacques-Eric Gottenberg; Johanna M W Hazes; Tom Huizinga; Meghna Jani; Dmitry Karateev; Marios Kouloumas; Tore Kvien; Zhanguo Li; Xavier Mariette; Iain McInnes; Eduardo Mysler; Peter Nash; Karel Pavelka; Gyula Poór; Christophe Richez; Piet van Riel; Andrea Rubbert-Roth; Kenneth Saag; Jose da Silva; Tanja Stamm; Tsutomu Takeuchi; René Westhovens; Maarten de Wit; Désirée van der Heijde Journal: Ann Rheum Dis Date: 2017-03-06 Impact factor: 19.103
Authors: Milou van Heuckelum; Elke Ge Mathijssen; Marcia Vervloet; Annelies Boonen; Renske Cf Hebing; Annelieke Pasma; Harald E Vonkeman; Mark H Wenink; Bart Jf van den Bemt; Liset van Dijk Journal: Patient Prefer Adherence Date: 2019-07-22 Impact factor: 2.711
Authors: Jennifer L Barton; Sheila Markwardt; Meike Niederhausen; Allison Schue; Jacob Dougherty; Patricia Katz; Somnath Saha; Edward H Yelin Journal: Arthritis Care Res (Hoboken) Date: 2021-09-27 Impact factor: 4.794
Authors: M J H Voshaar; B J F van den Bemt; M A F J van de Laar; A M van Dulmen; J E Vriezekolk Journal: BMC Health Serv Res Date: 2022-01-13 Impact factor: 2.655