Treatment adherence to disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis

Figures & data

Table 1 Demographic, clinical, and psychological characteristics of the patients with RA (n=122)

Characteristics	Descriptives
Age (years) mean ± SD	55.20±11.08
Sex, female, n (%)	104 (86)
Marital status, n (%)
Married	111 (91)
Other marital status	11 (9)
Education level, n (%)
Primary (0–6 years)	43 (35)
Secondary (7–12 years)	66 (54)
Higher (>12 years)	13 (11)
Employment, n (%)
Employed	79 (65)
Unemployed	43 (35)
Monthly per capita income, n (%)
<1,000 yuan	60 (49)
1,000–2,999 yuan	46 (38)
3,000–5,000 yuan	12 (10)
>5,000 yuan	4 (3)
Type of medical insurance, n (%)
With basic medical insurance	86 (71)
Self-pay, n (%)	30 (25)
Other, n (%)	6 (5)
Hospitalization, yes, n (%)	99 (81)
Tobacco use, yes, n (%)	9 (7)
Alcohol use, yes, n (%)	22 (18)
Family history, yes, n (%)	9 (7)
Disease duration, mean ± SD	8.76±9.20
Comorbid conditions, yes, n (%)	46 (38)
Total number of DMARDs, n (%)
One	31 (25)
Two	53 (43)
Three	33 (27)
>Three	5 (4)
ESR (mm/hour), mean ± SD	28.27±26.75
CRP (mg/L), mean ± SD	16.61±24.45
DAS28, mean ± SD	3.80±1.51
HAQ, mean ± SD	0.46±0.63
VAS global (mm), mean ± SD	4.32±2.76
VAS pain (mm), mean ± SD	3.94±3.18
HADS anxiety, n (%)	85 (70)
HADS depression, n (%)	84 (69)
Domains of SF-36, mean ± SD
PF	57.50±29.07
RP	21.31±36.46
BP	48.22±25.86
GH	42.34±21.17
VT	51.39±18.82
SF	61.17±27.07
RE	35.52±43.44
MH	61.21±18.39

Abbreviations: RA, rheumatoid arthritis; SD, standard deviation; DMARD, disease-modifying antirheumatic drug; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; DAS28, 28-joint Disease Activity Score; HAQ, health assessment questionnaire; VAS global, visual analog scale for general health; VAS pain, visual analog scale for pain; HADS, hospital anxiety and depression scale; SF-36, short form-36 questionnaire; PF, physical functioning; RP, role limitations due to physical problems; BP, body pain; GH, general health perception; VT, energy/vitality; SF, social functioning; RE, role limitations due to emotional problems; MH, mental health.

Table 2 Differences between demographic, clinical, and psychological characteristics of adherent and nonadherent patients

Characteristics	Adherent n=45	Nonadherent n=77	P-value
Age (years) mean ± SD	55.31±13.24	55.14±9.69	0.941
Sex, female, n (%)	40 (89)	64 (83)	0.386
Marital status, n (%)			0.772
Married	40 (89)	71 (92)
Other marital status	5 (11)	6 (8)
Education level, n (%)			0.016*
Primary (0–6 years)	22 (49)	21 (27)
Secondary (7–12 years)	20 (44)	46 (60)
Higher (>12 years)	3 (7)	10 (13)
Employment, n (%)			0.218
Employed	26 (58)	53 (69)
Unemployed	19 (42)	24 (31)
Monthly per capita income, n (%)			0.031*
<1,000 yuan	28 (62)	32 (42)
1,000–2,999 yuan	13 (29)	33 (43)
3,000–5,000 yuan	3 (7)	9 (12)
>5,000 yuan	1 (2)	3 (4)
Type of medical insurance, n (%)			0.981
With basic medical insurance	32 (71)	54 (70)
Self-pay	11 (24)	19 (25)
Other	2 (4)	4 (5)
Hospitalization, yes, n (%)	36 (80)	63 (82)	0.804
Tobacco use, yes, n (%)	3 (7)	6 (8)	1.000
Alcohol use, yes, n (%)	6 (13)	16 (21)	0.302
Family history, yes, n (%)	5 (11.1)	4 (5)	0.397
Disease duration, mean ± SD	8.64±9.17	8.84±9.27	0.734
Comorbid conditions, yes, n (%)	20 (44)	26 (34)	0.240
Total number of DMARDs, n (%)			0.032*
One	18 (40)	13 (17)
Two	15 (33)	38 (49)
Three	11 (24)	22 (29)
>Three	1 (2)	4 (5)
ESR (mm/hour), mean ± SD	24.42±24.86	30.52±27.70	0.129
CRP (mg/L), mean ± SD	17.74±29.00	15.94±21.53	0.947
DAS28, mean ± SD	3.73±1.55	3.85±1.50	0.673
HAQ, mean ± SD	0.53±0.70	0.42±0.58	0.595
VAS global (mm), mean ± SD	4.41±3.05	4.27±2.59	0.781
VAS pain (mm), mean ± SD	3.92±3.34	3.95±3.11	0.951
HADS anxiety, n (%)	29 (64)	56 (73)	0.337
HADS depression, n (%)	25 (56)	59 (77)	0.015*
Domains of SF-36, mean ± SD
PF	54.11±31.43	59.48±27.62	0.327
RP	25.56±39.70	18.83±34.45	0.239
BP	51.67±26.54	46.21±25.41	0.262
GH	42.53±25.01	42.23±18.75	0.945
VT	53.33±23.33	50.26±15.66	0.434
SF	62.50±31.19	60.39±24.54	0.680
RE	37.78±46.38	34.20±41.88	0.729
MH	58.58±23.30	62.75±14.76	0.283

Notes:

* P<0.05. Adherence, measured with the Compliance Questionnaire on Rheumatology, is expressed as dichotomous (<80% or ≥80% adherence) variable.

Abbreviations: SD, standard deviation; DMARD, disease-modifying antirheumatic drug; ESR, erythrocyte sedimentation rate; CRP, C-reactive protein; DAS28, 28-Joint Disease Activity Score; HAQ, health assessment questionnaire; VAS global, visual analog scale for general health; VAS pain, visual analog scale for pain; HADS, hospital anxiety and depression scale; SF-36, short form-36 questionnaire; PF, physical functioning; RP, role limitations due to physical problems; BP, body pain; GH, general health perception; VT, energy/vitality; SF, social functioning; RE, role limitations due to emotional problems; MH, mental health.

Table 3 Logistic regression analysis of demographic, medical, and psychological characteristics in relation to adherence

	Adherence	Beta	Standard error	P-value	Exp (B)	(95% CI)
Step 1	Education level	0.510	0.390	0.191	1.665	0.776, 3.573
	Monthly per capita income	0.693	0.370	0.061	1.999	0.968, 4.128
	HADS depression	1.356	0.484	0.005	3.882	1.502, 10.031
	Total number of DMARDs	0.657	0.273	0.016	1.929	1.130, 3.295
Step 2	Monthly per capita income	0.922	0.331	0.005**	2.515	1.315, 4.812
	HADS depression	1.460	0.477	0.002**	4.305	1.689, 10.973
	Total number of DMARDs	0.611	0.266	0.022*	1.843	1.094, 3.104

Notes:

* P<0.05,

** P<0.01.

Abbreviations: CI, confidence interval; HADS, hospital anxiety and depression scale; DMARD, disease-modifying antirheumatic drug.