TY - JOUR
T1 - Effectiveness of electronic drug monitoring feedback to increase adherence in patients with RA initiating a biological DMARD
T2 - a randomised clinical trial
AU - Hebing, Renske Cf
AU - Aksu, Iremnur
AU - Twisk, Jos Wr
AU - Bos, Wouter
AU - van den Bemt, Bart
AU - Nurmohamed, Michael T.
N1 - Funding Information: Funding Pfizer provided a grant for this study (53232353/WI193646). Publisher Copyright: © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
PY - 2022/2/4
Y1 - 2022/2/4
N2 - OBJECTIVE: Medication non-adherence in rheumatoid arthritis (RA) is associated with disease flares, increased disability and increased costs. This study assessed the effectiveness of electronic monitoring feedback (EMF) on medication adherence in patients with RA starting with or switching to a new biological disease-modifying antirheumatic drug (bDMARD). METHODS: In this randomised controlled trial, bDMARD starters were assigned to the intervention or control group and followed for 1 year. The intervention group received a needle container with a Medication Event Monitoring System (MEMS) cap registering patient's adherence to injections. Scores were calculated every 3 months with MEMS and motivational interviewing feedback was given. The control group received usual care. Effectiveness of EMF on adherence was measured with the medication possession ratio (MPR). RESULTS: 104 consecutive intervention patients were included and 102 controls. MPR was 0.95 (SD: 0.10) and 0.90 (0.16) after 12 months (B: 0.036, 95% CI: 0.001 to 0.007, p=0.045). bDMARD-naive patients receiving EMF achieved low disease activity (LDA) sooner compared with the control group, adjusted for baseline DAS (HR: 1.68, 95% CI: 1.00 to 2.81, p=0.050). Side effects and DAS28 were similar. CONCLUSION: EMF increased adherence for patients with RA starting with or switching to a bDMARD. Especially bDMARD-naive patients achieved LDA sooner compared with the control group, which holds promise for the future.
AB - OBJECTIVE: Medication non-adherence in rheumatoid arthritis (RA) is associated with disease flares, increased disability and increased costs. This study assessed the effectiveness of electronic monitoring feedback (EMF) on medication adherence in patients with RA starting with or switching to a new biological disease-modifying antirheumatic drug (bDMARD). METHODS: In this randomised controlled trial, bDMARD starters were assigned to the intervention or control group and followed for 1 year. The intervention group received a needle container with a Medication Event Monitoring System (MEMS) cap registering patient's adherence to injections. Scores were calculated every 3 months with MEMS and motivational interviewing feedback was given. The control group received usual care. Effectiveness of EMF on adherence was measured with the medication possession ratio (MPR). RESULTS: 104 consecutive intervention patients were included and 102 controls. MPR was 0.95 (SD: 0.10) and 0.90 (0.16) after 12 months (B: 0.036, 95% CI: 0.001 to 0.007, p=0.045). bDMARD-naive patients receiving EMF achieved low disease activity (LDA) sooner compared with the control group, adjusted for baseline DAS (HR: 1.68, 95% CI: 1.00 to 2.81, p=0.050). Side effects and DAS28 were similar. CONCLUSION: EMF increased adherence for patients with RA starting with or switching to a bDMARD. Especially bDMARD-naive patients achieved LDA sooner compared with the control group, which holds promise for the future.
KW - arthritis
KW - biological therapy
KW - rheumatoid
KW - therapeutics
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85124172698&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/35121638
U2 - https://doi.org/10.1136/rmdopen-2021-001712
DO - https://doi.org/10.1136/rmdopen-2021-001712
M3 - Article
C2 - 35121638
SN - 2056-5933
VL - 8
JO - RMD OPEN
JF - RMD OPEN
IS - 1
M1 - e001712
ER -