Objective: Efforts to improve adherence are based upon the assumption they will improve clinical outcomes. Few studies have examined that assumption. This study examined the relationship between change in adherence over six months and change in clinical outcome in patients with RA.
Design: This descriptive substudy of a larger study analyzed data collected at baseline and six months to determine the relationship between changes in adherence and changes in functional outcomes.
Population, Sample, Setting: Data were available on 173 individuals with RA of M=14 yr. The sample was female (79.8%), married (68.2%), well educated (93.1% >HS), white (95.4%), unemployed (64%), and late midlife (M = 59.9 yr).
Variables: Adherence was measured with the ARDEX electronic medication event monitor (MEMs). Functional outcome was measured by the MOS SF 36 and the Jette Functional Status Inventory.
Methods: At screening, Ss were asked to utilize the MEMs cap on their primary RA medication for four weeks and an additional 12 months. Data were downloaded and the MOS SF36 and Jette were administered at baseline and 6 months. Change scores were analyzed using the Pearson and Spearman correlation coefficients.
Findings: Improvement in doses taken was associated with improvement in role/physical (p=.03), pain (p=.04), and overall function (p=.035). Improvement in days adherent (p=.04) was associated with improvement in pain and overall function (p=.045). Improvement in optimal intervals was associated with improvement in pain (p=.036) and role/physical (p=.016).
Conclusions: Improvement in total doses taken and in dosing intervals appears to benefit the RA patient on ongoing regimen in pain reports, role function, and general overall function.
Implications: Adherence remains an important issue in management of the patient with RA.
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