Medication adherence among Albanian patients with rheumatoid arthritis

Abstract

Non-adherence in patients with rheumatoid arthritis (RA) using disease-modifying antirheumatic drugs (DMARDs) may lead to increased disease activity and symptoms, poorer quality of life and increased costs related to the disease treatment. The aim of this study is to determine the level of adherence to the treatment protocols of a chronic disease such as rheumatoid arthritis in the Albanian population and to investigate the predictors of adherence to medication. This is a single-center cross-sectional study in which included 125 patients diagnosed with RA recruited from the University Hospital “Mother Teresa” in Tirana, Albania from January to December 2013. The study was based on self-reporting by patients through a standard questionnaire divided into two parts. The first part consisted of a face-to-face interview with the patients in the hospital setting and the second part aimed at evaluation of the adherence to the prescribed therapy and was filled in via a telephone interview 4 weeks after the patient’s discharge from the hospital (117 patients participated in the second part of the interview). The Morisky Medication Adherence 4-item Scale (MMAS-4) was used to measure patients’ self-reported adherence to their medications. Factors affecting adherence are evaluated through the values of χ2 (chi-squared test of Pearson) for categorical variables and p (Student’s t-test) for continuous variables; 30.8% of full adherence to DMARDs was found in this study. Adherence to the medication was associated with education, income, number of comorbidities, use of biologic DMARDs, use of traditional medication and patients neglectful behavior toward medication. Three of the most important reasons reported by the patients as reasons for non-adherence to the medication were: the cost of the treatment; forgetfulness in taking the drug; and side effects of the treatment. The findings emphasize the need for intervention of the health authorities to improve the access to medicines for RA. Health professionals have a crucial role to inform and educate patients in order to support them in improving their adherence.