The effectiveness of therapy and the quality of life of patients with rheumatoid arthritis depending on the baseline treatment adherence

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OBJECTIVE

To evaluate the real-world effectiveness of therapy and quality of life (QoL) of patients with rheumatoid arthritis (RA) after one year of follow-up, depending on baseline compliance.

MATERIAL AND METHODS

The study included 132 females with confirmed RA (age 55.5±10.5 years, duration of RA 10.2 [4; 14] years), with moderate and high activity of RA (DAS 28 score of 5.0 [4.3; 5.8]). Clinical and laboratory examination was conducted: QoL assessment using HAQ questionnaire and EQ-5D. Pain was assessed on a visual analog scale (VAS), treatment adherence was evaluated using the questionnaire for qualitative assessment of adherence to Morisky-Green and the QAA-25 — questionnaire for quantitative assessment of adherence (according to N.A. Nikolaev). In 60 patients comparable in baseline characteristics of the disease with different levels of adherence, the examinations were carried out at baseline and after a year.

RESULTS

Low treatment adherence was shown by the Morisky-Green questionnaire in 68 (52.3%) of 132 and by the QAA-25 questionnaire in 33 (40.3%) of 82 females with RA. The least adherence to the recommendations for lifestyle modification was noted. Predictors of high treatment adherence were the young age of patients, a shorter duration of the disease, and a lower level of pain according to VAS. In patients with RA with initially low adherence to treatment after a year, an increase in the disease activity and a decrease in quality of life were noted, despite the therapy.

CONCLUSION

The relationships we have identified between baseline adherence, disease activity, and quality of life after one year of follow-up demonstrate the importance of considering baseline adherence. The least adherence was to lifestyle changes. Further research is needed on the factors affecting overall adherence and its components. The development of methods to increase treatment adherence can improve the effectiveness of therapy and the quality of life of patients with rheumatoid arthritis.

Keywords:

rheumatoid arthritis

treatment adherence

therapy effectiveness

quality of life

Authors:

Nikitina N.M.

Saratov State Medical University named after V.I. Razumovsky

SPIN RSCI: 6661-1830
Scopus AuthorID: 24338688700
ORCID: 0000-0002-0313-1191

Egorova E.V.

Regional Clinical Hospital

ORCID: 0000-0003-2818-115X

Bogdalova L.R.

Saratov State Medical University named after V.I. Razumovsky

ORCID: 0000-0003-2818-115X

Ziyadullaev Sh.Kh.

Samarkand State Medical University

SPIN RSCI: 9453-3639
Scopus AuthorID: 57214598227
ORCID: 0000-0002-9309-3933

Rebrov A.P.

Saratov State Medical University named after V.I. Razumovsky

SPIN RSCI: 9574-2067
Scopus AuthorID: 7005047527
ORCID: 0000-0002-3463-7734

Received:

14.11.2022

Accepted:

08.02.2023

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