title: Adherence to methotrexate in rheumatoid arthritis: a danish nationwide cohort study.
abstract: Objectives. To study adherence to methotrexate (MTX) and factors of importance thereof in patients with rheumatoid arthritis (RA). Methods. Patients with a hospital diagnosis of RA (ICD10 codes M05.X or M06.X) after January 1, 1997, and aged ≥18 years at the date of first diagnosis/contact, with at least one prescription of MTX (L04AX03), were included. Results. A total of 18,703 (47.6%) patients had ever used MTX among 39,286 with a diagnosis of RA; among the MTX users, 16,503 (88.2%) had filed more than one MTX prescription. The median time from diagnosis to first MTX prescription was 0.66 (IQR 0.26-1.80) years. In those who filed more than one MTX prescription, the mean adherence time for ≥7.5 mg MTX per week was 1,925 (IQR 467-3,056) days for patients treated in private practice versus 1,892 (IQR 452-3,316) days for patients treated in hospital. The main determinants of nonadherence were female gender, younger age, and time from diagnosis to initiation of MTX. Conclusions. Treatment at hospital or in private practice did not influence the adherence to MTX. Nonmodifiable factors of importance were gender and age, while adherence to MTX therapy decreased with time lapse between diagnosis and prescription.
authors: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital at Bispebjerg and Frederiksberg, 2000 Copenhagen F, Denmark ; Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Aalborg University, 9220 Aalborg, Denmark.
authors: Henning
authors: 0000-0002-7951-1668
authors: H
authors: Bliddal
authors: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital at Bispebjerg and Frederiksberg, 2000 Copenhagen F, Denmark ; Aalborg University Hospital, Clinical Institute, 9100 Aalborg, Denmark.
authors: Stine A
authors: SA
authors: Eriksen
authors: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital at Bispebjerg and Frederiksberg, 2000 Copenhagen F, Denmark.
authors: Robin
authors: R
authors: Christensen
authors: Department of Rheumatology, Region Hospital, 8600 Silkeborg, Denmark.
authors: Tove
authors: T
authors: Lorenzen
authors: Clinic of Rheumatology, 4000 Roskilde, Denmark.
authors: Michael S
authors: MS
authors: Hansen
authors: Copenhagen Centre for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, 2600 Glostrup, Denmark.
authors: Mikkel
authors: M
authors: Østergaard
authors: Department of Rheumatology, Copenhagen University Hospital, 2900 Gentofte, Denmark.
authors: Lene
authors: L
authors: Dreyer
authors: Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC 20057, USA.
authors: George
authors: 0000-0002-4035-7632
authors: G
authors: Luta
authors: Department of Endocrinology, Aalborg University Hospital, Aalborg, Denmark.
authors: Peter
authors: P
authors: Vestergaard