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J Rheumatol. 2016 Jun;43(6):1027-9. doi: 10.3899/jrheum.151136. Epub 2016 May 1.

Agreement between Rheumatologist and Patient-reported Adherence to Methotrexate in a US Rheumatoid Arthritis Registry.

Author information

1
From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC. jrcurtis@uabmc.edu.
2
From the University of Alabama at Birmingham, Birmingham, Alabama; Consortium of Rheumatology Researchers of North America (CORRONA) LLC, Southborough; University of Massachusetts, Worcester, Massachusetts, USA.J.R. Curtis, MD, MS, MPH, University of Alabama at Birmingham; A. Bharat, MD, MPH, University of Alabama at Birmingham; L. Chen, PhD, University of Alabama at Birmingham; J.D. Greenberg, MD, MPH, CORRONA LLC; L. Harrold, MD, MPH, University of Massachusetts; J.M. Kremer, MD, CORRONA LLC; T. Sommers, MS, CORRONA LLC; D. Pappas, MD, MPH, CORRONA LLC.

Abstract

OBJECTIVE:

Rheumatologists have limited tools to assess medication adherence. The extent to which methotrexate (MTX) adherence is overestimated by rheumatologists is unknown.

METHODS:

We deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. Patient self-report was the gold standard compared to MTX recorded in the registry.

RESULTS:

Response rate to the survey was 44%. Of 228 patients whose rheumatologist reported current MTX at the time of the most recent registry visit, 45 (19.7%) had discontinued (n = 19, 8.3%) or missed ≥ 1 dose in the last month (n = 26, 11.4%). For the subgroup whose rheumatologist also confirmed at the next visit that they were still taking MTX (n = 149), only 2.6% reported not taking it, and 10.7% had missed at least 1 dose.

CONCLUSION:

MTX use was misclassified for 13%-20% of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.

KEYWORDS:

ADHERENCE; METHOTREXATE; PERSISTENCE; RHEUMATOID ARTHRITIS

PMID:
27134256
PMCID:
PMC4891269
DOI:
10.3899/jrheum.151136
[Indexed for MEDLINE]
Free PMC Article

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