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Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study
BACKGROUND: Assessing medication adherence in rheumatoid arthritis (RA) is clinically significant as low adherence is associated with high disease activity. Self-reported medication adherence surveys have been shown to have problems with overestimation of adherence due to social desirability bias. H...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758812/ https://www.ncbi.nlm.nih.gov/pubmed/36527156 http://dx.doi.org/10.1186/s41927-022-00305-8 |
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author | Yajima, Nobuyuki Kawaguchi, Takashi Takahashi, Ryo Nishiwaki, Hiroki Toyoshima, Yoichi Oh, Koei Odai, Tsuyoshi Kanai, Takayuki Morisky, Donald E. Yamaguchi, Takuhiro Kasama, Tsuyoshi |
author_facet | Yajima, Nobuyuki Kawaguchi, Takashi Takahashi, Ryo Nishiwaki, Hiroki Toyoshima, Yoichi Oh, Koei Odai, Tsuyoshi Kanai, Takayuki Morisky, Donald E. Yamaguchi, Takuhiro Kasama, Tsuyoshi |
author_sort | Yajima, Nobuyuki |
collection | PubMed |
description | BACKGROUND: Assessing medication adherence in rheumatoid arthritis (RA) is clinically significant as low adherence is associated with high disease activity. Self-reported medication adherence surveys have been shown to have problems with overestimation of adherence due to social desirability bias. However, no MTX adherence studies adjusted for social desirability have been conducted to date. This study aimed to evaluate adherence to MTX and perform an investigatory search for factors associated with MTX adherence including social desirability. METHODS: This cross-sectional multicenter study was conducted among adult RA patients consuming oral MTX for ≥ 3 months. We examined the distribution of MTX adherence, according to the eight-item Morisky Medication Adherence Scale (MMAS-8). Social desirability was using the Social Desirability Scale (SDS). Furthermore, an exploratory factor analysis involving social desirability was examined to identify factors associated with MTX adherence using linear regression analysis. To deal with missing values, we used multiple imputations with chained equations methods. RESULTS: A total of 165 RA patients were enrolled. The median age was 64 years, and 86.1% were women. Based on the MMAS-8, low, medium, and high adherences were noted in 12.1%, 60.0%, and 27.9% of participants, respectively. High social desirability (coefficient, 0.14; 95% confidence interval [CI], 0.05–0.23; p < 0.05) and high age (coefficient per 10 years, 0.16; 95% CI, 0.01–0.03; p < 0.05) were associated with high MTX adherence, whereas full-time work was negatively associated with high MTX adherence (coefficient, -0.50; 95% CI, -0.95–-0.05; p < 0.05). CONCLUSIONS: A large proportion of patients with RA do not take MTX as prescribed. High social desirability, high educational level, and non-full-time work may be associated with high MTX adherence. Physicians should confirm MTX adherence before switching or adding disease-modifying anti-rheumatic drugs in cases of uncontrolled disease activity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41927-022-00305-8. |
format | Online Article Text |
id | pubmed-9758812 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-97588122022-12-18 Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study Yajima, Nobuyuki Kawaguchi, Takashi Takahashi, Ryo Nishiwaki, Hiroki Toyoshima, Yoichi Oh, Koei Odai, Tsuyoshi Kanai, Takayuki Morisky, Donald E. Yamaguchi, Takuhiro Kasama, Tsuyoshi BMC Rheumatol Research BACKGROUND: Assessing medication adherence in rheumatoid arthritis (RA) is clinically significant as low adherence is associated with high disease activity. Self-reported medication adherence surveys have been shown to have problems with overestimation of adherence due to social desirability bias. However, no MTX adherence studies adjusted for social desirability have been conducted to date. This study aimed to evaluate adherence to MTX and perform an investigatory search for factors associated with MTX adherence including social desirability. METHODS: This cross-sectional multicenter study was conducted among adult RA patients consuming oral MTX for ≥ 3 months. We examined the distribution of MTX adherence, according to the eight-item Morisky Medication Adherence Scale (MMAS-8). Social desirability was using the Social Desirability Scale (SDS). Furthermore, an exploratory factor analysis involving social desirability was examined to identify factors associated with MTX adherence using linear regression analysis. To deal with missing values, we used multiple imputations with chained equations methods. RESULTS: A total of 165 RA patients were enrolled. The median age was 64 years, and 86.1% were women. Based on the MMAS-8, low, medium, and high adherences were noted in 12.1%, 60.0%, and 27.9% of participants, respectively. High social desirability (coefficient, 0.14; 95% confidence interval [CI], 0.05–0.23; p < 0.05) and high age (coefficient per 10 years, 0.16; 95% CI, 0.01–0.03; p < 0.05) were associated with high MTX adherence, whereas full-time work was negatively associated with high MTX adherence (coefficient, -0.50; 95% CI, -0.95–-0.05; p < 0.05). CONCLUSIONS: A large proportion of patients with RA do not take MTX as prescribed. High social desirability, high educational level, and non-full-time work may be associated with high MTX adherence. Physicians should confirm MTX adherence before switching or adding disease-modifying anti-rheumatic drugs in cases of uncontrolled disease activity. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s41927-022-00305-8. BioMed Central 2022-12-17 /pmc/articles/PMC9758812/ /pubmed/36527156 http://dx.doi.org/10.1186/s41927-022-00305-8 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Yajima, Nobuyuki Kawaguchi, Takashi Takahashi, Ryo Nishiwaki, Hiroki Toyoshima, Yoichi Oh, Koei Odai, Tsuyoshi Kanai, Takayuki Morisky, Donald E. Yamaguchi, Takuhiro Kasama, Tsuyoshi Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
title | Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
title_full | Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
title_fullStr | Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
title_full_unstemmed | Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
title_short | Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
title_sort | adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9758812/ https://www.ncbi.nlm.nih.gov/pubmed/36527156 http://dx.doi.org/10.1186/s41927-022-00305-8 |
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