Association of medication beliefs, self-efficacy, and adherence in a diverse cohort of adults with rheumatoid arthritis

Caroline McCulley, Patricia Katz, Laura Trupin, Edward H. Yelin, Jennifer Barton

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objective. Rheumatoid arthritis (RA) patients’ adherence to disease-modifying antirheumatic drugs (DMARD) is often suboptimal. We examined associations among medication beliefs, self-efficacy, and adherence to medications in RA. Methods. Data were from a longitudinal observational cohort of persons with RA. Subjects completed telephone interviews on self-reported adherence, self-efficacy, demographics, and the Beliefs about Medicines Questionnaire (BMQ), which assesses beliefs in necessity and beliefs about taking medication. Bivariate and multivariate logistic regression identified correlates of poor adherence to synthetic DMARD and prednisone as well as to biologic therapy, including medication concerns and necessity. Results. There were 362 patients who reported taking a synthetic DMARD and/or prednisone. Of these, 14% and 21% reported poor adherence to oral DMARD or prednisone, and biologics, respectively. There were 64% who reported concern about taking medicines, 81% about longterm effects, and 47% about becoming too dependent on medicines. In multivariate analyses, the BMQ necessity score was independently associated with better adherence to oral DMARD or prednisone (adjusted OR 0.61, 95% CI 0.41–0.91), while self-efficacy was associated with greater odds of poor adherence to oral medications (adjusted OR 1.23, 95% CI 1.01–1.59). Beliefs in medicines and self-efficacy were not associated with adherence to biologics. Conclusion. In a diverse cohort of patients with RA, stronger beliefs in the necessity of medication were associated with better adherence to oral DMARD or prednisone, while higher self-efficacy was associated with poor adherence. Providers can play important roles in eliciting patient beliefs about medications to improve adherence and ultimately health outcomes.

Original languageEnglish (US)
Pages (from-to)1636-1642
Number of pages7
JournalJournal of Rheumatology
Volume45
Issue number12
DOIs
StatePublished - Dec 1 2018

Fingerprint

Self Efficacy
Antirheumatic Agents
Rheumatoid Arthritis
Prednisone
Mouth Diseases
Biological Products
Medicine
Biological Therapy
Medication Adherence
Patient Compliance
Multivariate Analysis
Logistic Models
Demography
Interviews
Health

Keywords

  • Adherence
  • Disease-modifying antirheumatic drugs
  • Medication beliefs
  • Rheumatoid arthritis
  • Self-efficacy

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Association of medication beliefs, self-efficacy, and adherence in a diverse cohort of adults with rheumatoid arthritis. / McCulley, Caroline; Katz, Patricia; Trupin, Laura; Yelin, Edward H.; Barton, Jennifer.

In: Journal of Rheumatology, Vol. 45, No. 12, 01.12.2018, p. 1636-1642.

Research output: Contribution to journalArticle

McCulley, Caroline ; Katz, Patricia ; Trupin, Laura ; Yelin, Edward H. ; Barton, Jennifer. / Association of medication beliefs, self-efficacy, and adherence in a diverse cohort of adults with rheumatoid arthritis. In: Journal of Rheumatology. 2018 ; Vol. 45, No. 12. pp. 1636-1642.
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N2 - Objective. Rheumatoid arthritis (RA) patients’ adherence to disease-modifying antirheumatic drugs (DMARD) is often suboptimal. We examined associations among medication beliefs, self-efficacy, and adherence to medications in RA. Methods. Data were from a longitudinal observational cohort of persons with RA. Subjects completed telephone interviews on self-reported adherence, self-efficacy, demographics, and the Beliefs about Medicines Questionnaire (BMQ), which assesses beliefs in necessity and beliefs about taking medication. Bivariate and multivariate logistic regression identified correlates of poor adherence to synthetic DMARD and prednisone as well as to biologic therapy, including medication concerns and necessity. Results. There were 362 patients who reported taking a synthetic DMARD and/or prednisone. Of these, 14% and 21% reported poor adherence to oral DMARD or prednisone, and biologics, respectively. There were 64% who reported concern about taking medicines, 81% about longterm effects, and 47% about becoming too dependent on medicines. In multivariate analyses, the BMQ necessity score was independently associated with better adherence to oral DMARD or prednisone (adjusted OR 0.61, 95% CI 0.41–0.91), while self-efficacy was associated with greater odds of poor adherence to oral medications (adjusted OR 1.23, 95% CI 1.01–1.59). Beliefs in medicines and self-efficacy were not associated with adherence to biologics. Conclusion. In a diverse cohort of patients with RA, stronger beliefs in the necessity of medication were associated with better adherence to oral DMARD or prednisone, while higher self-efficacy was associated with poor adherence. Providers can play important roles in eliciting patient beliefs about medications to improve adherence and ultimately health outcomes.

AB - Objective. Rheumatoid arthritis (RA) patients’ adherence to disease-modifying antirheumatic drugs (DMARD) is often suboptimal. We examined associations among medication beliefs, self-efficacy, and adherence to medications in RA. Methods. Data were from a longitudinal observational cohort of persons with RA. Subjects completed telephone interviews on self-reported adherence, self-efficacy, demographics, and the Beliefs about Medicines Questionnaire (BMQ), which assesses beliefs in necessity and beliefs about taking medication. Bivariate and multivariate logistic regression identified correlates of poor adherence to synthetic DMARD and prednisone as well as to biologic therapy, including medication concerns and necessity. Results. There were 362 patients who reported taking a synthetic DMARD and/or prednisone. Of these, 14% and 21% reported poor adherence to oral DMARD or prednisone, and biologics, respectively. There were 64% who reported concern about taking medicines, 81% about longterm effects, and 47% about becoming too dependent on medicines. In multivariate analyses, the BMQ necessity score was independently associated with better adherence to oral DMARD or prednisone (adjusted OR 0.61, 95% CI 0.41–0.91), while self-efficacy was associated with greater odds of poor adherence to oral medications (adjusted OR 1.23, 95% CI 1.01–1.59). Beliefs in medicines and self-efficacy were not associated with adherence to biologics. Conclusion. In a diverse cohort of patients with RA, stronger beliefs in the necessity of medication were associated with better adherence to oral DMARD or prednisone, while higher self-efficacy was associated with poor adherence. Providers can play important roles in eliciting patient beliefs about medications to improve adherence and ultimately health outcomes.

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