The impact of using musculoskeletal ultrasound imaging and other influencing factors on medication adherence in patients with rheumatoid arthritis: a qualitative study.
The impact of using musculoskeletal ultrasound imaging and other influencing factors on medication adherence in patients with rheumatoid arthritis: a qualitative study.
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DOI：
10.2147/ppa.s99702
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发表时间：
2016
影响因子：
2.2
通讯作者：
Greenfield S
中科院分区：
文献类型：
--
作者：
Kumar K;Raza K;Gill P;Greenfield S
药物治疗可以缓解类风湿性关节炎（RA）的症状并限制疾病进展。尽管如此，不遵守药物治疗在RA中很常见。我们探讨了RA患者对病情缓解抗风湿药物（DMARDs）依从性高低的决定因素，并提供了改善DMARDs依从性的方法建议。RA患者是从之前参加过测量药物依从性水平的问卷调查的患者中识别出来的。20例患者参与了研究（10例高依从性和10例低依从性，根据对药物依从性报告量表的反应确定）。深入的个人半结构化访谈，直到达到数据饱和。访谈记录和分析使用一个恒定的比较方法。确定了与依从性相关的四个主题：1）症状严重程度; 2）疾病感知; 3）DMARD的感知获益和风险;以及4）有关RA和DMARD的信息质量和数量。此外，还收集了患者关于优化DMARD依从性的策略的建议，这些建议属于以下主题：1）肌肉骨骼超声解释疾病过程，并提供有关其疾病活动有效控制程度的客观反馈; 2）更好地解释控制不良的RA的后果; 3）与健康专业人员的良好关系。患者对药物的信念，对RA的看法，以及对DMARD信息的满意度影响他们对DMARD的依从性。使用肌肉骨骼超声对发炎关节进行成像可能有助于提高患者对DMARD的依从性。
Medication can ease symptoms and limit disease progression in rheumatoid arthritis (RA). Despite this, nonadherence to medication is common in RA. We explored the determinants of high and low adherence to disease-modifying antirheumatic drugs (DMARDs) in patients with RA and provide suggestions on approaches to improving adherence to DMARDs. Patients with RA were identified from those who had previously participated in a questionnaire measuring levels of medication adherence. Twenty patients participated (ten high and ten low adherers, as determined by responses to the Medication Adherence Report Scale). In-depth individual semistructured interviews were undertaken until data saturation was reached. Interviews were transcribed and analyzed using a constant comparative method. Four main themes related to adherence were identified: 1) symptom severity; 2) illness perception; 3) perceived benefits and risks of DMARDs; and 4) the quality and quantity of information about RA and DMARDs. In addition, patients’ suggestions about strategies to optimize adherence to DMARDs were captured and they fell within the following themes: 1) musculoskeletal ultrasound to explain the disease process and to provide objective feedback about the extent to which their disease activity is being effectively controlled; 2) better explanations of the consequences of poorly controlled RA; and 3) a good relationship with the health professional. Patients’ beliefs about medicines, perceptions about RA, and level of satisfaction with information about DMARDs influenced their adherence to DMARDs. The use of musculoskeletal ultrasound to image the inflamed joint may help to improve patient adherence to DMARDs.