Rheumatoid Arthritis

In an article by J. Hill, the drug adherence rates in rheumatic diseases were investigated and explained. Adherence for this purpose would be defined as whether or not a patient follows the health plan created by their physician and/or health provider. This is best not described as a number, or calculated by counting the pills; a patient can take all the pills prescribed but not in the correct dosage, therefore not adhering to the care plan.

Patient adherence to medication dosage is important for many reasons, which may depend on the patient’s condition and/or the prescribed medication. Some drugs have a narrow therapeutic index which if taken incorrectly could cause more problems for the patient both financially and physically. The most common medications prescribed for patients with rheumatoid arthritis are Disease Modifying Anti-Rheumatic Drugs (DMARDs) and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs). Patients must take these drugs correctly because otherwise they can experience severe side effects and/or toxicity.

This article described many different studies testing adherence in patients with proper patient education versus those without patient education, aka teaching the patient about the drug itself, its side effects, and what they can do if they experience any side effects. For example, rheumatoid arthritis patients who are taking DMARDs must be aware and monitoring for side effects for a few months, because sometimes the side effects of these drugs take time to show.

Patients do not adhere to medication regiments for many different reasons. In one study, many patients using NSAIDS discontinued and/or reduced their prescription (therefore not adhering to their regiment) because their symptoms were relieved. Another study showed that patients with complex daily medication regiments are less likely to adhere to it. However, whatever the reason, patients with rheumatoid arthritis will notice a positive effect of adhering to their medication regiment in their current health and mobility, and keep them from long term disability.

References:
http://www3.interscience.wiley.com/journal/112224266/abstract
http://www.bbc.co.uk/health/conditions/rheumatoid1.shtml