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Study Finds Suboptimal Adherence to MTX Treatment in Patients With RA
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Researchers of an Internet study found rheumatologists overestimated adherence to methotrexate treatment in between 13% to 20% of their patients.
Jeffrey R. Curtis, MD, MS, MPH, from the University of Alabama at Birmingham, and colleagues sent an Internet survey to 984 patients with rheumatoid arthritis in the Consortium of Rheumatology Researchers of North America (CORRONA) Effectiveness Registry to Study Therapies for Arthritis and Inflammatory Conditions (CERTAIN) substudy, according to the study abstract. Of these patients, 44% responded. The survey polled patients about their current methotrexate (MTX) use and weekly adherence to MTX treatment. Selected patients had their methotrexate use confirmed at their last physician office visit, and the follow-up registry contained a subgroup of patients still taking MTX as confirmed by their doctors.
Jeffrey R. Curtis
The researchers found that of 228 patients who were taking MTX at the last registry visit, 19 patients (8.3%) had discontinued the treatment and 26 patients (11.4%) had missed one dose or more within the past month, according to the abstract. Within the subgroup of patients who were doctor-confirmed as still taking MTX, 2.6% reported not taking the medication and 10.7% reported missing a dose.
Curtis and colleagues said the presentation of the survey helped limit social desirability bias in cases in which patients who had stopped treatment or missed a dose may not have answered truthfully.
“Few past studies in rheumatology have been able to leverage orthogonal sources of information that bring together independent adherence assessments from both rheumatologists and patients,” Curtis and colleagues wrote. “Moreover, while it is possible that rheumatologists may have instructed patients to discontinue MTX after the office visit, the subgroup analysis that restricted the analysis to people reported by the physician to be taking MTX at the next registry visit helped address this concern.” – by Jeff Craven
Disclosure: The researchers received support from CORRONA Inc., the Agency for Healthcare Research and Quality, and Genentech.
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