An Exploratory Study of Factors Associated with Medication Adherence in Chinese Rheumatoid Arthritis Patients

Mang He,1,2 Yan-Juan Chen,1 Lu Huang,3 Yong-Qiao Zhang,4 Si-Jin Zhao,4 Xiao-Long Chen,4 Chuan-Jie Yang,4 Yu-Zhuo Luo,4 Mei Tian,1 Yong Chen1 1Department of Rheumatology and Immunology, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People’s Republic of China; 2Department of Endocrinology, Zunyi Hospital of Traditional Chinese Medicine, Zunyi, Guizhou, People’s Republic of China; 3Department of Pediatric Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, People’s Republic of China; 4The First Clinical Institute, Zunyi Medical University, Zunyi, Guizhou, People’s Republic of ChinaCorrespondence: Yong Chen, Department of Rheumatology and Immunology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, Guizhou, People’s Republic of China, Email [email protected] Mei Tian, Department of Rheumatology and Immunology, Affiliated Hospital of Zunyi Medical University, 149 Dalian Road, Huichuan District, Zunyi, Guizhou, People’s Republic of China, Email [email protected]: This study aims to estimate the prevalence of medication adherence in Chinese patients with RA and to identify factors influencing it.Patients and Methods: A cross - sectional study was conducted, involving 1137 RA patients who were treated at a university hospital in Guizhou, China. Sociodemographic data, medication adherence, patient satisfaction, and quality of life (QoL) were collected through face-to-face interviews, while disease course and comorbidities (including pneumonia and gastrointestinal conditions) were extracted from hospital information systems (HIS). Multifactorial logistic regression analysis was applied to assess the factors influencing patients’ adherence. Subsequently, mediation analysis was employed to delve deeper into the interrelationships among the variables.Results: The proportion of patients with good adherence was 61.57%. Multivariable logistic regression analysis revealed that patient satisfaction (OR=2.079), treatment regimen (OR=0.280), and pulmonary infection (OR=1.695) were independently associated with medication adherence. The QoL scores for the groups demonstrating good adherence and satisfaction were markedly higher compared to those exhibiting non-adherence and dissatisfaction (P< 0.001). Medication adherence mediated the positive relationship between patient satisfaction and mental health (MH) in QoL (β= 0.140).Conclusion: Our study demonstrates a significant positive correlation between patient satisfaction and medication adherence. Improving patients’ satisfaction with treatment is feasible approaches to enhancing medication adherence. However, Single-center studies limit the generalizability of results, and potential confounding by unmeasured variables should be considered.Keywords: rheumatoid arthritis, adherence, patient satisfaction, regression analysis, mediation analysis