Relationship of adherence to treatment with disease activity, physical function, quality of life, treatment satisfaction and beliefs in axial spondyloarthritis patients

Aim of the work: To investigate the relationship of adherence to treatment with disease activity, physical function, quality of life, satisfaction with treatment and patient's beliefs about medications in axial spondyloarthritis (axSpA) patients. Patients and methods: This study included 54 axSpA patients; disease activity and physical function were assessed using Bath Ankylosing Spondylitis Disease Activity and Functional Indices (BASDAI and BASFI respectively). The following questionnaires were conducted: Medication Adherence Report Scale (MARS-5), Treatment Satisfaction Questionnaire for medication (version 1.4), Beliefs about Medicines Questionnaire specific for medications of certain disease (BMQ-specific), and Euro quality of life (QoL) five-dimension EQ-5D questionnaire. Results: There was no difference between patients with high and low adherence regarding health care system, residency, education, or number of medications. BASDAI, BASFI, and concern scores (p = 0.001, p = 0.01, p = 0.01) were significantly higher, while effectiveness score, overall satisfaction score, and EQ-5D (p = 0.008, p = 0.01, p = 0.001) were significantly lower in patients with low adherence. There was a significant inverse relation between MARS-5 and BASDAI, BASFI, and concern scores (p < 0.001, p = 0.017 and p = 0.02), while there was a significant correlation between MARS-5 and effectiveness score, side effect score, and overall satisfaction score (p < 0.001, p = 0.01 and p = 0.004). Conclusion: Adherence to treatment was associated with low diseases activity, better functional ability, and improved QoL of axSpA patients. Satisfaction with treatment and beliefs about medications had a significant impact on adherence to treatment, where patients reporting high effectiveness, high overall satisfaction about the drugs, fewer side effects and less concern about side effects exhibited high adherence levels. (c) 2021 THE AUTHORS. Publishing services by ELSEVIER B.V. on behalf of The Egyptian Society of Rheumatic Diseases This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).