Evaluation of a medication optimization intervention and predictors of medication adherence, patient satisfaction and medication adverse events in patients with rheumatoid arthritis

Background: Because effective treatment for rheumatoid arthritis (RA) is dependent on medication use, medication optimization is critically important. Medication adherence, patient satisfaction with care and medication adverse events are core concepts of medication optimization that are either a significant problem and/or understudied in patients with RA. Objective: To (1) evaluate treatment effects from a medication optimization intervention; (2) assess treatment differences and changes over time in medication adherence, patient satisfaction, and medication adverse events; and (3) to determine whether age, gender, provider trust, and disease activity affect these outcomes. Methods: We conducted a prospective, longitudinal intervention study (N = 143 RA patients) using repeated measures models. Results: We did not identify significant intervention effects. For both the medication adherence and patient satisfaction models, the significant predictors in the model included age, gender and trust in provider. Older age, female gender (relative to male), and greater trust in the provider were associated with increased medication adherence scores and patient satisfaction. For the adverse events model, the only significant predictor in the model was gender. Compared with males, females were more likely to report experiencing adverse events. Time was significantly associated with decreased experiences of adverse events. Conclusion: This study has identified important predictors of medication adherence, patient satisfaction and medication adverse events in a sample of patients with RA which can facilitate targeted approaches to improve adherence in those high-risk groups.