ORIGINAL PAPER
Selected psychological factors and medication adherence in patients with rheumatoid arthritis
More details
Hide details
1
Department of Psychology, Medical University of Silesia, Katowice, Poland
Submission date: 2021-01-27
Final revision date: 2021-02-28
Acceptance date: 2021-03-23
Online publication date: 2021-04-27
Publication date: 2021-04-28
Reumatologia 2021;59(2):90-97
KEYWORDS
TOPICS
ABSTRACT
Introduction:
The aim of the study was to determine the relationship between medication adherence (MA) and selected psychological factors in a group of patients with rheumatoid arthritis (RA).
Material and methods:
The cross-sectional study was conducted in four rheumatology outpatient clinics in Silesia, Poland. The tests used were the Medication Adherence Questionnaire (MAQ), the Multidimensional Health Locus of Control Scale (MHLC), the Coping Inventory for Stressful Situations (CISS), and the Mindful Attention Awareness Scale (MAAS). The analysis involved 106 adult patients diagnosed with RA at least 6 months before, who were prescribed medication, with disease at any stage and with stable comorbidities. Software was used to perform analyses of frequency, basic descriptive statistics, including the Kolmogorov-Smirnov test, Student’s t-test for independent samples, intergroup univariate variance, Pearson’s r correlation coefficient, Spearman’s rank correlation coefficient, Fisher’s exact test and stepwise linear regression.
Results:
Powerful Others Health Locus of Control (PHLC), Internal Health Locus of Control (IHLC) and age of the subjects, F(3, 102) = 8.05; p < 0.001 explained 16.8% of the variation in the adherence level for the entire group. In the group of women PHLC and IHLC, F(2, 80) = 10.04; p < 0.001 were included in the model, which explained 18.1% of variation in MA. PHLC was the most significant factor in the group of women ( = 0.55; p < 0.001) and in the entire group ( = 0.48; p < 0.001). In the group of men, Social Diversion Style (SDS), F(1, 21) = 5.81; p = 0.02 was included in the model, which explained 17.9% of the variation in the MA level.
Conclusions:
The study identified some psychological predictors of adherence, which explained 16.8% of the variability. Factors increasing the likelihood of medication adherence in patients with rheumatoid arthritis include a strong belief in the power of others, low level of internal health locus of control, and advanced age.
REFERENCES (38)
1.
Kucharz EJ. Reumatoidalne zapalenie stawów. In: Wielka Interna. Reumatologia. Puszczewicz MJ (ed.). Medical Tribune, Warszawa 2016: 75–88.
2.
Kwiatkowska B. Reaktywne zapalenie stawów. In: Reumatologia kliniczna. Zimmermann-Górska I (ed.). Wyd. Lekarskie PZWL, Warszawa 2008: 746–757.
3.
Filipowicz-Sosnowska A. Reumatoidalne zapalenie stawów. In: Interna Szczeklika. Podręcznik chorób wewnętrznych. Szczeklik A (ed.). Medycyna Praktyczna, Kraków 2018: 1926–1940.
4.
Scott DL, Wolfe F, Huizinga TW. Rheumatoid arthritis. Lancet 2010; 376: 1094–1108, DOI: 10.1016/S0140-6736(10)60826-4.
5.
Matcham F, Scott IC, Rayner L, et al. The impact of rheumatoid arthritis on quality-of-life assessed using the SF-36: a systematic review and meta-analysis. Semin Arthritis Rheum 2014; 44: 123–130, DOI: 10.1016/j.semarthrit.2014.05.001.
6.
Safiri S, Kolahi AA, Hoy D, et al. Global, regional and national burden of rheumatoid arthritis 1990–2017: a systematic analysis of the Global Burden of Disease study 2017. Ann Rheum Dis 2019; 78: 1463–1471, DOI: 10.1136/annrheumdis-2019-215920.
7.
Batko B, Stajszczyk M, Świerkot J, et al. Prevalence and clinical characteristics of rheumatoid arthritis in Poland: a nationwide study. Arch Med Sci 2019; 15: 134–140, DOI: 10.5114/aoms.2017.71371.
8.
Smolen JS, Landewé R, Breedveld FC, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2013 update. Ann Rheum Dis 2014; 73: 492–509, DOI: 10.1136/annrheumdis-2013-204573.
9.
Fielis-Giemza A. Strategia leczenia chorych na reumatoidalne zapalenie stawów z uwzględnieniem obecności czynników „złej prognozy”. Varia Medica 2017; 1: 92–98 [Published online].
10.
van den Bemt BJ, Zwikker HE, van den Ende CH. Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature. Expert Rev Clin Immunol 2012; 8: 337–351, DOI: 10.1586/eci.12.23.
11.
Sharma S, Roshi, Tandon VR, Mahajan A. A Study evaluating adherence and compliance of anti-rheumatic drugs in women suffering from rheumatoid arthritis. J Clin Diagn Res 2015; 9: OC01–OC4, DOI: 10.7860/JCDR/2015/15806.6729.
12.
Salt E, Frazier SK. Adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. Orthopaedic Nursing 2010; 29: 260–275, DOI: 10.1097/NOR.0b013e3181e5c2c9.
13.
Molloy GJ, O’Carroll RE, Ferguson E. Conscientiousness and medication adherence: a meta-analysis. Ann Behav Med 2014; 47: 92–101, DOI: 10.1007/s12160-013-9524-4.
14.
Náfrádi L, Nakamoto K, Schulz PJ. Is patient empowerment the key to promote adherence? A systematic review of the relationship between self-efficacy, health locus of control and medication adherence. PLoS One 2017; 12: e0186458, DOI: 10.1371/journal.pone.0186458.
15.
Endler NS, Parker JD. Multidimensional assessment of coping: a critical evaluation. J Pers Soc Psychol 1990; 58: 844–854, DOI: 10.1037//0022-3514.58.5.844.
16.
Gruszczyńska M, Bąk-Sosnowska M, Szemik S. Selected psychological aspects and medication adherence in oncological patients. Cancer Med 2020; 9: 943–950, DOI: 10.1002/cam4.2691.
17.
Kabat-Zinn J. Full catastrophe living. Nurse Pract 1992, DOI: 10.1097/00006205-199202000-00020 [Published online].
18.
Carey MP, Dunne EM, Norris A, et al. Telephone-delivered mindfulness training to promote medication adherence and reduce sexual risk behavior among persons living with HIV: an exploratory clinical trial. AIDS Behav 2020; 24: 1912–1928, DOI: 10.1007/s10461-019-02768-2.
19.
Çetin N, Aylaz R. The effect of mindfulness-based psychoeducation on insight and medication adherence of schizophrenia patients. Arch Psychiatr Nurs 2018; 32: 737–744, DOI: 10.1016/j.apnu.2018.04.011.
20.
Brown KW, Ryan RM. The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 2003; 84: 822–848, DOI: 10.1037/0022-3514.84.4.822.
21.
Folkman S, Lazarus RS. If it changes it must be a process: study of emotion and coping during three stages of a college examination. J Pers Soc Psychol 1985; 48: 150–170, DOI: 10.1037//0022-3514.48.1.150.
22.
Wallston KA, Wallston BS, DeVellis R. Development of the Multidimensional Health Locus of Control (MHLC) Scales. Health Educ Monogr 1978; 6: 160–170, DOI: 10.1177/109019 817800600107.
23.
Culig J, Leppée M. From Morisky to Hill-bone; self-reports scales for measuring adherence to medication. Coll Antropol 2014; 38: 55–62.
24.
Toll BA, McKee SA, Martin DJ, et al. Factor structure and validity of the Medication Adherence Questionnaire (MAQ) with cigarette smokers trying to quit. Nicotine Tob Res 2007; 9: 597–605, DOI: 10.1080/14622200701239662.
25.
Morisky DE, Ang A, Krousel-Wood M, Ward HJ. Predictive validity of a medication adherence measure in an outpatient setting. J Clin Hypertens (Greenwich) 2008; 10: 348–354, DOI: 10.1111/j.1751-7176.2008.07572.x.
26.
Juczyński Z. Narzędzia pomiaru w psychologii zdrowia. Przegląd Psychologiczny 1999; 42: 43–56.
27.
Strelau J, Jaworowska A, Wrześniewski K, Szczepaniak P. CISS – Kwestionariusz Radzenia Sobie w Sytuacjach Stresowych. Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego, Warszawa 2009.
28.
Radoń S. Walidacja Skali Świadomej Obecności. Studia Psychologica 2014; 14: 51–70.
29.
Brandstetter S, Hertig S, Loss J, et al. ‘The lesser of two evils…’ – views of persons with rheumatoid arthritis on medication adherence: a qualitative study. Psychol Health 2016; 31: 675–692, DOI: 10.1080/08870446.2016.1139111.
30.
Prudente LR, Diniz Jde S, Ferreira TX, et al. Medication adherence in patients in treatment for rheumatoid arthritis and systemic lupus erythematosus in a university hospital in Brazil. Patient Prefer Adherence 2016; 10: 863–870, DOI: 10.2147/PPA.S79451.
31.
Adina TS, Mihaela-Simona S, Lucia CP, et al. The influence of socio-demographic factors, lifestyle and psychiatric indicators on adherence to treatment of patients with rheumatoid arthritis: a cross-sectional study. Medicina (Kaunas) 2020; 56: 178, DOI: 10.3390/medicina56040178.
32.
Clifford S, Barber N, Horne R. Understanding different beliefs held by adherers, unintentional nonadherers, and intentional nonadherers: application of the Necessity-Concerns Framework. J Psychosom Res 2008; 64: 41–46, DOI: 10.1016/j.jpsychores.2007.05.004.
33.
Kumar K, Raza K, Gill P, Greenfield S. The impact of using musculoskeletal ultrasound imaging and other influencing factors on medication adherence in patients with rheumatoid arthritis: a qualitative study. Patient Prefer Adherence 2016; 10: 1091–1100, DOI: 10.2147/PPA.S99702.
34.
OECD/EU. Health at a Glance: Europe 2018 – State of health in the EU Cycle 2018, DOI: 10.1787/9789264012639-en.
35.
Rodin J. Aging and health: effects of the sense of control. Science 1986; 233: 1271–1276, DOI: 10.1126/science.3749877.
36.
Berner C, Erlacher L, Fenzl KH, Dorner TE. Medication adherence and coping strategies in patients with rheumatoid arthritis: a cross-sectional study. Int J Rheumatol 2019; 2019: 4709645, DOI: 10.1155/2019/4709645.
37.
Salmoirago-Blotcher E, Carey MP. Can mindfulness training improve medication adherence? Integrative review of the current evidence and proposed conceptual model. Explore (NY) 2018; 14: 59–65, DOI: 10.1016/j.explore.2017.09.010.
38.
Park DC, Hertzog C, Leventhal H, et al. Medication adherence in rheumatoid arthritis patients: older is wiser. J Am Geriatr Soc 1999; 47: 172–183, DOI: 10.1111/j.1532-5415.1999.tb04575.x.
Copyright: © Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji w Warszawie. This is an Open Access journal, all articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License (
https://creativecommons.org/licenses/by-nc-sa/4.0/), allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.