• Journal Article

Assessing methotrexate adherence in rheumatoid arthritis: A cross-sectional survey


DiBenedetti, D., Zhou, X., Reynolds, M., Ogale, S., & Best, J. H. (2015). Assessing methotrexate adherence in rheumatoid arthritis: A cross-sectional survey. Rheumatology and Therapy, 2(1), 73-84. DOI: 10.1007/s40744-015-0011-1


Methods<br>Patient panel members in the US self-reporting a diagnosis of RA of ?3 months’ and current MTX use of ?4 weeks’ duration, with or without concomitant use of another RA prescription medication, participated in this cross-sectional, web-based survey.<br><br>Results<br>The sample population (251 MTX monotherapy, 250 MTX combination therapy) was predominantly female, white, non-Hispanic, and educated; 48% were 18–44 years-old, 47% had medical comorbidities, 66% were first diagnosed with RA ?5 years earlier, 51% reported MTX use of <1 year, and 83% reported oral MTX use. Forty-two percent reported not taking MTX exactly as prescribed. Reasons for nonadherence included forgetting to take it (33%), not needing it when feeling well (24%), and concern about long-term safety (24%). Among nonadherent patients, 53% took smaller doses, 52% skipped doses, and 6% reported other nonprescribed ways of taking MTX. Younger age, male sex, and shorter duration of MTX use were associated with poorer self-reported adherence. Compared with monotherapy patients, combination therapy patients, particularly those taking ?2 other RA prescriptions, were less likely to report high adherence.<br><br>Conclusion<br>Nearly half the sample reported poor MTX adherence because they forgot to take it, thought it was not needed when they felt well, or had long-term safety concerns. Patients taking ?2 other RA prescription medications were less likely to report good adherence. Reducing treatment burden without sacrificing efficacy may be a strategy worth evaluating.<br>