Medication Adherence Is Poor in Patients With RA Who Receive NSAIDs

June 20, 2012

Outcomes in patients with rheumatoid arthritis who receive NSAIDs are worse than those in patients who receive other prescription medications, according to findings from the National Health and Wellness Survey.

Outcomes in patients with rheumatoid arthritis (RA) who receive NSAIDs are worse than those in patients who receive other prescription medications, according to findings from the National Health and Wellness Survey (NHWS). NSAID users are more likely to be intentionally nonadherent to their drug regimen than patients who are receiving biologic or nonbiologic disease-modifying antirheumatic drugs (DMARDs).

Overall, 32% of NSAID users are intentionally nonadherent, compared with 13% of nonbiologic DMARD users and 15% of biologic DMARD users, the survey showed. NSAID users in the survey had substantially lower mental quality of life scores (42.96 vs 47.57) and physical quality of life scores (35.10 vs 38.35) than nonbiologic DMARD users. More NSAID users are obese than biologic DMARD users (43% vs 30%), and NSAID users have lower incomes (14% vs 32%). In addition, NSAID users are more likely to be uninsured than biologic and nonbiologic DMARD users.

Patients' adherence to medication regimens for chronic conditions is poor overall, and given the progressive nature of RA, poor adherence may contribute to poor health outcomes and increased costs, it was noted. The differences between NSAID and DMARD users in rates of adherence and health outcomes suggest that NSAID users try to manage their RA symptoms occasionally rather than view RA as a condition that needs to be managed on an ongoing basis. Helping patients who use NSAIDs gain access to disease-modifying therapies may help increase their adherence and health outcomes.

Adherence was measured with the Morisky Medication Adherence Scale (4-item version), and health status was measured using the Short Form-12v2. The NHWS, conducted by Kantar Health, was presented recently at the 17th Annual International Meeting for the International Society for Pharmacoeconomic and Outcomes Research in Washington, DC.