Investigating adherence to methotrexate in patients with rheumatoid arthritis

Abstract

Background: Methotrexate (MTX) is the first-line treatment for rheumatoid arthritis (RA), yet response is not universal and patient non-adherence may partially explain this. Given that achieving remission remains a priority for rheumatologists, very little is known about their views and clinical approach when prescribing MTX. Aims: The aims of the Thesis were; 1) to quantify the rate of adherence to MTX in the UK, 2) to identify the reasons for non-adherence and 3) to investigate the predictors of non-adherence; from the patient and rheumatologist perspectives. Methods: The Rheumatoid Arthritis Medication Study is a prospective cohort of patients with RA who are incident MTX users, followed over their first year of MTX therapy. MTX adherence and reasons for non-adherence were quantified utilising patient diaries that captured weekly MTX use from baseline to six months. The multivariable effects of baseline characteristics on the odds of being ever non-adherent at six months were calculated. In a subsample, positive, negative and uncertain illness appraisals were coded from free text contained in patient diaries. The MTX related appraisals made during therapy of adherent and non-adherent (100% versus

Date of Award	1 Aug 2018
Original language	English
Awarding Institution	The University of Manchester
Supervisor	Lis Cordingley (Supervisor), Kimme Hyrich (Supervisor) & Suzanne Verstappen (Supervisor)