A critical review of compliance studies in rheumatoid arthritis.

Nineteen studies of treatment compliance in rheumatoid arthritis (RA) patients have been critically appraised to assess the magnitude and determinants of noncompliance in this population. Deficiencies in study methodology undermined the possibility of firm conclusions on the influence of various factors on compliance in RA populations. Nevertheless, it is apparent that noncompliance with treatments for RA is a major problem that hitherto has not been widely considered. Compliance with prescribed drug regimens varied from 16% to 84% among these studies. With physiotherapy regimens, compliance rates varied from 39% to 65%, while for splint-usage, rates varied from 25% to 65%. No consistent correlation has been demonstrated between compliance and age, sex, treatment side effects, disease severity, or drug dose frequency. Gaps in our present day knowledge have been detailed and the need for further research is outlined.

[1]  F. Brand,et al.  Effect of economic barriers to medical care on patients' noncompliance. , 1977, Public health reports.

[2]  L S Robertson,et al.  A controlled study of the effect of television messages on safety belt use. , 1974, American journal of public health.

[3]  F. H. Tyler,et al.  GLUCOCORTICOID TOXICITY: SINGLE CONTRASTED WITH DIVIDED DAILY DOSES OF PREDNISOLONE. , 1965, Journal of chronic diseases.

[4]  Bender Lf,et al.  Problem of home treatment in arthritis. , 1957 .

[5]  P. Lee,et al.  Drug compliance in outpatients with rheumatoid arthritis. , 1979, Australian and New Zealand journal of medicine.

[6]  F. Krusen,et al.  PHYSICAL THERAPY APPLIED AT HOME FOR ARTHRITIS: A FOLLOW-UP STUDY, WITH A SUPPLEMENTARY SUMMARY OF THE SEDIMENTATION RATE OF ERYTHROCYTES IN TWO HUNDRED AND TWENTY-NINE CASES OF ARTHRITIS , 1943 .

[7]  W. Buchanan,et al.  Patient compliance: a novel method of testing non-steroidal antiinflammatory analgesics in rheumatoid arthritis. , 1979, The Journal of rheumatology.

[8]  W. Downie,et al.  Steroid cards: patient compliance. , 1977, British medical journal.

[9]  K. Brandt,et al.  Use of resting splints by patients with rheumatoid arthritis. , 1981, The American journal of occupational therapy : official publication of the American Occupational Therapy Association.

[10]  J. Fries,et al.  Nonsteroidal anti-inflammatory agents in rheumatoid arthritis and ankylosing spondylitis. , 1981, JAMA.

[11]  A. Donabedian,et al.  Follow-up study of chronically ill patients discharged from hospital , 1964 .

[12]  C. Joyce.  Patient co-operation and the sensitivity of clinical trials. , 1962, Journal of chronic diseases.

[13]  J. R. Ward,et al.  Patient non-compliance within the context of seeking medical care for arthritis. , 1973, Journal of chronic diseases.

[14]  R. Deyo,et al.  Compliance with therapeutic regimens in arthritis: issues, current status, and a future agenda. , 1982, Seminars in arthritis and rheumatism.

[15]  R. Deyo,et al.  Noncompliance with arthritis drugs: magnitude, correlates, and clinical implications. , 1981, The Journal of rheumatology.

[16]  A. Lilienfeld,et al.  Why patients don't follow medical advice: a study of children on long-term antistreptococcal prophylaxis. , 1969, The Journal of pediatrics.

[17]  R B Haynes,et al.  Predicting compliance with a regimen of digoxin therapy in family practice. , 1980, Canadian Medical Association journal.

[18]  J. Nicholas,et al.  Splinting in rheumatoid arthritis: I. Factors affecting patient compliance. , 1982, Archives of physical medicine and rehabilitation.

[19]  G. Bole,et al.  Family support, health beliefs, and therapeutic compliance in patients with rheumatoid arthritis. , 1979, Patient counselling and health education.

[20]  B. Hsi,et al.  Estimating a patient's cooperation with his regimen , 1971, The American journal of the medical sciences.

[21]  Alvin I. Mushlin,et al.  Diagnosing Potential Noncompliance: Physicians' Ability in a Behavioral Dimension of Medical Care , 1977 .

[22]  J. R. Ward,et al.  Family expectations and arthritis patient compliance to a hand resting splint regimen. , 1970, Journal of chronic diseases.

[23]  Davis Lj,et al.  Medical recommendations--followed or ignored? Factors influencing compliance in arthritis. , 1976 .

[24]  R. M. Mason,et al.  Assessment of drugs in out-patients with rheumatoid arthritis. Evaluation of methods and a comparison of mefenamic and flufenamic acids with phenylbutazone and aspirin. , 1967, Annals of the rheumatic diseases.

[25]  Tinkelman Dg,et al.  Compliance differences following administration of theophylline at six- and twelve-hour intervals. , 1980 .

[26]  J. Dequeker,et al.  Compliance and long-term effect of azathioprine in 65 rheumatoid arthritis cases. , 1982, Annals of the rheumatic diseases.

[27]  A. Stunkard,et al.  Effectiveness of a self-help group in obesity control. A further assessment. , 1974, Archives of internal medicine.