title: The Rate of Adherence to Antiarthritis Medications and Associated Factors among Patients with Rheumatoid Arthritis: A Systematic Literature Review and Metaanalysis.
abstract: OBJECTIVE
  Reported adherence in rheumatoid arthritis (RA) varies widely (10.5-98.5%). Variability may result in part from different methods used to measure adherence. Our aims were to quantify adherence to antiarthritis medications for each method and to identify variability and associated factors.
  
  
  METHODS
  The systematic literature review examined PubMed, the Cochrane central database, and article reference lists from 1970 to November 2014. Papers with medication adherence data (disease-modifying antirheumatic drugs, steroids, and nonsteroidal antiinflammatory drugs) in adult patients with RA or data on associated factors were included. Adherence rate was recorded for each method. Random-effect metaanalysis estimated adherence for different evaluation methods.
  
  
  RESULTS
  Adherence rate was 66% (95% CI 0.58-0.75). There were no differences in adherence among different measurement methods (interview, questionnaires, etc.). Regression analysis showed that adherence decreases during followup. Among 100 possible factors potentially effecting adherence, 7 adherence-associated factors were found in at least 2 different studies. These were the use of infliximab compared with etanercept or methotrexate (MTX), use of MTX compared to sulfasalazine or to etanercept, belief in the necessity of the medications, older age, and white race.
  
  
  CONCLUSIONS
  Overall adherence rate was 66%. We suggest that readers appraise adherence studies according to the medications evaluated, the validity of the method, and the scales and cutpoints.
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence.
authors.forename: Anat
authors.initials: A
authors.lastname: Scheiman-Elazary
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence.
authors.forename: Lewei
authors.initials: L
authors.lastname: Duan
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence.
authors.forename: Courtney
authors.initials: C
authors.lastname: Shourt
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence.
authors.forename: Harsh
authors.initials: H
authors.lastname: Agrawal
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence.
authors.forename: David
authors.initials: D
authors.lastname: Ellashof
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence.
authors.forename: M
authors.initials: M
authors.lastname: Cameron-Hay
authors.affiliation: From the Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles (UCLA); Division of General Internal Medicine and Health Services Research, UCLA, Los Angeles, California; Division of Cardiology, Department of Internal Medicine, University of Missouri, Columbia, Missouri; Department of Anthropology, Miami University, Oxford, Ohio; University of Washington, Seattle, Washington, USA; University of Florence, Florence, Italy.A. Scheiman-Elazary, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; L. Duan, MS, Division of General Internal Medicine and Health Services Research, UCLA; Courtney Shourt, MD, Division of Rheumatology, Department of Medicine, David Geffen School of Medicine, UCLA; H. Agrawal, MD, Division of Cardiology, Department of Internal Medicine, University of Missouri; D. Ellashof, PhD, Division of General Internal Medicine and Health Services Research, UCLA; M. Cameron-Hay, PhD, Department of Anthropology, Miami University; D.E. Furst, MD, University of Washington, and University of Florence. defurst@mednet.ucla.edu.
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Furst
mesh_terms: D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016903:Drug Monitoring
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents
keywords: ADHERENCE; MEDICATIONS; METAANALYSIS; RHEUMATOID ARTHRITIS; RISK FACTORS