Medication adherence and disease activity in patients with ankylosing spondylitis: A pilot study

Ankylosing spondylitis (AS) is a chronic inflammatory rheumatic disease requiring long-term pharmacological treatment and active patient engagement. Low to moderate levels of treatment adherence were observed in most participants, while disease activity was predominantly moderate to high. A statistically significant moderate positive association was identified between reported adherence and symptom burden, indicating higher adherence among patients with more active disease. Educational level emerged as a key determinant of adherence, with lower adherence observed in patients with higher education. Disease activity was significantly influenced by sex, comorbidities, smoking status, physical inactivity, and the use of biological therapy. These findings suggest that adherence behavior is dynamic and strongly driven by symptom severity rather than functioning as an independent predictor of disease control. The results highlight the importance of continuous monitoring of medication-taking behavior and the need for targeted pharmaceutical care interventions, particularly during periods of lower symptom intensity. Larger longitudinal studies are warranted to further clarify adherence patterns and their impact on long-term outcomes.