Beliefs of Moroccan patients with chronic inflammatory rheumatic diseases regarding medication: related factors and correlation with therapeutic adherence.
BMQ
Beliefs about medicines
Chronic inflammatory rheumatic diseases
Therapeutic adherence
Journal
BMC rheumatology
ISSN: 2520-1026
Titre abrégé: BMC Rheumatol
Pays: England
ID NLM: 101738571
Informations de publication
Date de publication:
18 Sep 2024
18 Sep 2024
Historique:
received:
29
08
2023
accepted:
11
09
2024
medline:
20
9
2024
pubmed:
20
9
2024
entrez:
19
9
2024
Statut:
epublish
Résumé
Medication adherence is one of the key elements of the management of patients with chronic inflammatory rheumatic diseases (CIRDs), adherence/medication regimes are prone to being influenced by beliefs about medicines; such beliefs can influence the management and quality of life of patients. Several factors may be associated with these beliefs, including demographic and clinical factors, as well as socio-psychological factors. The aim of this study is to assess beliefs regarding medications among Moroccan patients with CIRDs, the factors associated with these beliefs, and the correlation of these factors with medication adherence. This cross-sectional study included patients with CIRDs. Sociodemographic data, comorbidities, and information about CIRDs (type, disease duration, pain evaluation, disease activity and treatments) were collected. Beliefs regarding medication were assessed by the Belief about Medicine Questionnaire (BMQ). Therapeutic adherence was assessed using the Arabic version of the Compliance Questionnaire in Rheumatology (CQR). Sociopsychological factors, such as catastrophism and trust in physicians, were assessed by the Pain Catastrophizing Scale (PCS) and the Trust in Physicians Scale (TPS), respectively. Our sample included 189 patients. The average age was 47.49 ± 13.7; 52.4% had comorbidities; and 49.2% had a low level of education. Of the patients, 49.7% were on glucocorticoids, 61.9% on conventional synthetic disease-modifying antirheumatic drugs and 6.3% on biologics. The median necessity-concern differential was 6 [1-12]. Of the patients, 67.4% strongly believed that medication was essential to maintain their health. The long-term side effects were the main concerns about medicines (51.3%). In a multivariate analysis, there was a statistically significant association between low level of education, catastrophizing, methotrexate use, and trust in the physician as independent factors and the BMQ necessity-concern differential as the dependent factor. There was also a significant correlation between CQR and the BMQ necessity score. Moroccan patients with CIRDs have a rather positive perception of their medication. This perception seems to influence their adherence to treatment. Low levels of education, catastrophizing, methotrexate use, and trust in physicians are the most important factors associated with patients' beliefs regarding medication.
Sections du résumé
BACKGROUND
BACKGROUND
Medication adherence is one of the key elements of the management of patients with chronic inflammatory rheumatic diseases (CIRDs), adherence/medication regimes are prone to being influenced by beliefs about medicines; such beliefs can influence the management and quality of life of patients. Several factors may be associated with these beliefs, including demographic and clinical factors, as well as socio-psychological factors. The aim of this study is to assess beliefs regarding medications among Moroccan patients with CIRDs, the factors associated with these beliefs, and the correlation of these factors with medication adherence.
MATERIAL AND METHOD
METHODS
This cross-sectional study included patients with CIRDs. Sociodemographic data, comorbidities, and information about CIRDs (type, disease duration, pain evaluation, disease activity and treatments) were collected. Beliefs regarding medication were assessed by the Belief about Medicine Questionnaire (BMQ). Therapeutic adherence was assessed using the Arabic version of the Compliance Questionnaire in Rheumatology (CQR). Sociopsychological factors, such as catastrophism and trust in physicians, were assessed by the Pain Catastrophizing Scale (PCS) and the Trust in Physicians Scale (TPS), respectively.
RESULT
RESULTS
Our sample included 189 patients. The average age was 47.49 ± 13.7; 52.4% had comorbidities; and 49.2% had a low level of education. Of the patients, 49.7% were on glucocorticoids, 61.9% on conventional synthetic disease-modifying antirheumatic drugs and 6.3% on biologics. The median necessity-concern differential was 6 [1-12]. Of the patients, 67.4% strongly believed that medication was essential to maintain their health. The long-term side effects were the main concerns about medicines (51.3%). In a multivariate analysis, there was a statistically significant association between low level of education, catastrophizing, methotrexate use, and trust in the physician as independent factors and the BMQ necessity-concern differential as the dependent factor. There was also a significant correlation between CQR and the BMQ necessity score.
CONCLUSION
CONCLUSIONS
Moroccan patients with CIRDs have a rather positive perception of their medication. This perception seems to influence their adherence to treatment. Low levels of education, catastrophizing, methotrexate use, and trust in physicians are the most important factors associated with patients' beliefs regarding medication.
Identifiants
pubmed: 39300521
doi: 10.1186/s41927-024-00419-1
pii: 10.1186/s41927-024-00419-1
doi:
Types de publication
Journal Article
Langues
eng
Pagination
45Informations de copyright
© 2024. The Author(s).
Références
Smolen JS, Landewé RBM, Bergstra SA, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update annals of the. Rheumatic Dis. 2023;82:3–18. https://doi.org/10.1136/ard-2022-223356 .
doi: 10.1136/ard-2022-223356
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(4):337–51. https://doi.org/10.1586/eci.12.23 .
doi: 10.1586/eci.12.23
pubmed: 22607180
World Health Organization. (2003). Adherence to long-term therapies: evidence for action. World Health Organization. https://apps.who.int/iris/handle/10665/42682 . Accessed 6 July 2023.
Bluett J, Morgan C, Thurston L, et al. Impact of inadequate adherence on response to subcutaneously administered anti-tumour necrosis factor drugs: results from the Biologics in Rheumatoid Arthritis Genetics and Genomics Study Syndicate cohort. Rheumatology (Oxford). 2015;54(3):494–9. https://doi.org/10.1093/rheumatology/keu358 .
doi: 10.1093/rheumatology/keu358
pubmed: 25213131
Li L, Cui Y, Yin R, et al. Medication adherence has an impact on disease activity in rheumatoid arthritis: a systematic review and meta-analysis. Patient Prefer Adherence. 2017;11:1343–56. https://doi.org/10.2147/PPA.S140457 .
doi: 10.2147/PPA.S140457
pubmed: 28831245
pmcid: 5553350
Horne R, Chapman SC, Parham R, et al. Understanding patients’ adherence-related beliefs about medicines prescribed for long-term conditions: a meta-analytic review of the necessity-concerns Framework. PLoS ONE. 2013;8(12):e80633. https://doi.org/10.1371/journal.pone.0080633 .
doi: 10.1371/journal.pone.0080633
pubmed: 24312488
pmcid: 3846635
Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569–81. https://doi.org/10.1002/art.27584 .
doi: 10.1002/art.27584
pubmed: 20872595
Rudwaleit M, van der Heijde D, Landewé R, et al. The Assessment of SpondyloArthritis International Society classification criteria for peripheral spondyloarthritis and for spondyloarthritis in general. Ann Rheum Dis. 2011;70(1):25–31. https://doi.org/10.1136/ard.2010.133645 .
doi: 10.1136/ard.2010.133645
pubmed: 21109520
Alhalaiqa F, Masa’Deh R, Batiha AM, et al. Validity of Arabic Version of beliefs about Medication Questionnaire. Clin Nurs Res. 2015;24(5):539–55. https://doi.org/10.1177/1054773814545383 .
doi: 10.1177/1054773814545383
pubmed: 25106809
Aljohani R, Aljohani Z, Aljohani R, et al. Saudi cultural adaptation of the compliance questionnaire of Rheumatology for rheumatoid arthritis patients on disease modifying anti-rheumatic drugs (DMARDs). Saudi Pharm J. 2021;29(5):377–83. https://doi.org/10.1016/j.jsps.2021.03.007 .
doi: 10.1016/j.jsps.2021.03.007
pubmed: 34135664
pmcid: 8180466
Anderson LA, Dedrick RF. Development of the Trust in Physician scale: a measure to assess interpersonal trust in patient-physician relationships. Psychol Rep. 1990;67(3 Pt 2):1091–100. https://doi.org/10.2466/pr0.1990.67.3f.1091 .
doi: 10.2466/pr0.1990.67.3f.1091
pubmed: 2084735
Terkawi AS, Sullivan M, Abolkhair A, et al. Development and validation of arabic version of the pain catastrophizing scale. Saudi J Anaesth. 2017;11(Suppl 1):S63–70. https://doi.org/10.4103/sja.SJA_130_17 .
doi: 10.4103/sja.SJA_130_17
pubmed: 28616005
pmcid: 5463568
McCulley C, Katz P, Trupin L, et al. Association of Medication Beliefs, Self-efficacy, and adherence in a diverse cohort of adults with rheumatoid arthritis. J Rheumatol. 2018;45(12):1636–42. https://doi.org/10.3899/jrheum.171339 .
doi: 10.3899/jrheum.171339
pubmed: 30219761
pmcid: 6364826
Cea-Calvo L, Raya E, Marras C, et al. The beliefs of rheumatoid arthritis patients in their subcutaneous biological drug: strengths and areas of concern. Rheumatol Int. 2018;38(9):1735–40. https://doi.org/10.1007/s00296-018-4097-y .
doi: 10.1007/s00296-018-4097-y
pubmed: 29959469
Ahijón-Lana M, Gutiérrez-Ortega C, Robles-Sánchez I et al. The influence of patient´s perspective in therapeutic adherence in rheumatoid arthritis: a case study from Spain. ARP Rheumatol 2022 Jan-Mar;1(1):4–11.
Tosato S, Bonetto C, Zanini A, et al. Clinical and psychological characteristics associated with negative beliefs and concerns about treatment necessity in rheumatic diseases. Sci Rep. 2022;12(1):22603. https://doi.org/10.1038/s41598-022-27046-5 .
doi: 10.1038/s41598-022-27046-5
pubmed: 36585438
pmcid: 9803630
Shiyanbola OO, Farris KB, Chrischilles E. Concern beliefs in medications: changes over time and medication use factors related to a change in beliefs. Res Social Adm Pharm. 2013 Jul-Aug;9(4):446–57. https://doi.org/10.1016/j.sapharm.2012.07.003 .
Hayden C, Neame R, Tarrant C. Patients’ adherence-related beliefs about methotrexate: a qualitative study of the role of written patient information. BMJ Open. 2015;5(5):e006918. https://doi.org/10.1136/bmjopen-2014-006918 .
doi: 10.1136/bmjopen-2014-006918
pubmed: 25995237
pmcid: 4442177
Suh YS, Cheon YH, Kim HO, et al. Medication nonadherence in Korean patients with rheumatoid arthritis: the importance of belief about medication and illness perception. Korean J Intern Med. 2018;33(1):203–10. https://doi.org/10.3904/kjim.2015.383 .
doi: 10.3904/kjim.2015.383
pubmed: 28859470
Horne R, Albert A, Boone C. Relationship between beliefs about medicines, adherence to treatment, and disease activity in patients with rheumatoid arthritis under subcutaneous anti-TNFα therapy. Patient Prefer Adherence. 2018;12:1099–111. https://doi.org/10.2147/PPA.S166451 .
doi: 10.2147/PPA.S166451
pubmed: 29970960
pmcid: 6021009
Kumar K, Gordon C, Toescu V, et al. Beliefs about medicines in patients with rheumatoid arthritis and systemic lupus erythematosus: a comparison between patients of south Asian and white British origin. Rheumatology (Oxford). 2008;47(5):690–7. https://doi.org/10.1093/rheumatology/ken050 .
doi: 10.1093/rheumatology/ken050
pubmed: 18375972
Abdulridha SH, Kadhim DJ, Razzak SAA. Beliefs about Medicines among a sample of Iraqi patients with psoriasis. Innov Pharm. 2021;12(1). https://doi.org/10.24926/iip.v12i1.3584 .
Neame R, Hammond A. Beliefs about medications: a questionnaire survey of people with rheumatoid arthritis. Rheumatology (Oxford). 2005;44(6):762–7. https://doi.org/10.1093/rheumatology/keh587 .
doi: 10.1093/rheumatology/keh587
pubmed: 15741193
Kumar K, Gordon C, Barry R, et al. It’s like taking poison to kill poison but I have to get better’: a qualitative study of beliefs about medicines in rheumatoid arthritis and systemic lupus erythematosus patients of south Asian origin. Lupus. 2011;20(8):837–44. https://doi.org/10.1177/0961203311398512 .
doi: 10.1177/0961203311398512
pubmed: 21511761
Martin RW, Head AJ, René J. Patient decision-making related to antirheumatic drugs in rheumatoid arthritis: the importance of patient trust of physician. J Rheumatol. 2008;35(4):618–24.
pubmed: 18278840
Barton JL, Trupin L, Tonner C, et al. English language proficiency, health literacy, and trust in physician are associated with shared decision making in rheumatoid arthritis. J Rheumatol. 2014;41(7):1290–7. https://doi.org/10.3899/jrheum.131350 .
doi: 10.3899/jrheum.131350
pubmed: 24931952
pmcid: 4286372
Edwards RR, Cahalan C, Mensing G, et al. Pain, catastrophizing, and depression in the rheumatic diseases. Nat Rev Rheumatol. 2011;7(4):216–24. https://doi.org/10.1038/nrrheum.2011.2 .
doi: 10.1038/nrrheum.2011.2
pubmed: 21283147
Evers AW, Kraaimaat FW, Geenen R, et al. Pain coping and social support as predictors of long-term functional disability and pain in early rheumatoid arthritis. Behav Res Ther. 2003;41(11):1295–310. https://doi.org/10.1016/s0005-7967(03)00036-6 .
doi: 10.1016/s0005-7967(03)00036-6
pubmed: 14527529
Wilk M, Łosińska K, Pripp AH, et al. OP0089 do pain catastrophizing reduce the likelihood of remission in patients with chronic inflammatory joint disorders? Ann Rheum Dis. 2021;80:48–9.
doi: 10.1136/annrheumdis-2021-eular.3715