Adherence to and Persistence with Disease Modifying Anti-rheumatic Drugs in Rheumatoid Arthritis Patients in Taiwan

• Main Authors: Yi-HanLiu, 劉宜涵
• Other Authors: Yea-Huei Kao Yang
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/55243879379840139509

碩士 === 國立成功大學 === 臨床藥學與藥物科技研究所 === 102 === Disease-modifying antirheumatic drugs (DMARDs) are the major treatment of rheumatoid arthritis (RA). Although DMARDs are efficacious and highly recommended, literature demonstrated that the adherence to and persistence with treatments are generally poor. This study aimed to evaluate the adherence to and persistence with DMARDs among established RA patients in Taiwan, identify potential predictor for adherence, and assess the association between nonadherence and patients’ outcome. We conducted a retrospective cohort study by analyzing the National Health Insurance Research Database of Taiwan from 2001 to 2010. RA patients issued with Catastrophic Illness certification for the first time between 2002 and 2009 were included. We defined the application date for Catastrophic Illness certification as index date. Adherence was examined by medication possession ratio (MPR). In order to evaluate persistence, we calculated the time to discontinuation after the index date. Logistic regression was used to analyze predictors of adherence. A total of 18,463 patients with RA were included. During the 1st-year-period after the index date, 34.4% of patients discontinued the DMARDs therapy. The median persistence was 315 days. The mean MPR was 60.26% (SD, 35.97). Within 3 years of index date, the adherence became lower as each year elapsed. Some factors such as female, living in rural area and low clinic visits predicted nonadherence. The persistence with DMARDs therapy was generally well, but the adherence was suboptimal. Further studies are needed to confirm the effect of nonadherence on patients’ outcome.