Can patient navigators ameliorate Disease‐Modifying Antirheumatic Drugs (DMARDs) adherence?

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Can patient navigators ameliorate Disease‐Modifying Antirheumatic Drugs (DMARDs) adherence?

“Patient navigators do not ameliorate oral DMARD adherence”, confirms latest study published in Arthritis Care & Research Journal

Disease-modifying antirheumatic drugs (DMARDs) are a group of medications which slows the progression rate of rheumatoid arthritis (RA), prevents joint damage and decreases pain and inflammation. Although non-adherence to DMARDs is fairly common, many reviews have revealed that 49%-99% of patients suffering from RA are adherent based on the measurement method of adherence. Non-adherence leads to adverse events and further aggravates the treatment course.

Candace H Feldman et al. Investigated whether patient navigators (laypersons trained in care coordination, motivational interviewing, basic pharmacology, and disease management) ameliorated oral DMARD adherence.

Total 107 patients aged ≥18 years with systemic rheumatic diseases who initiated an oral DMARD within 6 months were enrolled for the study. For 6 months, the navigators interacted with these patients up to 2-4 times/ week. At baseline and 6 months, the patients finished the validated surveys (Morisky Medication Adherence Scale [MMAS-8], Mental Health Inventory [MHI-5], Beliefs about Medicines Questionnaire, and Brief Illness Perception Questionnaire). The outcomes were compared using the paired t-tests. Multivariable linear regression was used to examine the relationship of age, race/ethnicity, insurance, and MHI-5 with a change in MMAS-8 score.

Overall, 69 (64%) completed baseline and 6-month MMAS-8 surveys among the 107 patients. The mean± SD age was 55 ± 16 years with 93% being females. Borderline adherence was revealed as the mean ± SD baseline MMAS-8 score was 6.7 ± 1.3 and <68 suggested the presence of any depressive symptoms as the mean ± SD MHI-5 score was 60.8 ± 9.1. No notable changes were seen in MMAS-8 or MHI-5 after 6 months. The patients explained fewer medication concerns, but a more threatening perception of illness. For each 5-year increase in age, the multivariable model portrayed a minor change in MMAS-8. 

Thus, it was found that there was no change in adherence from baseline. There is a need for a multicenter, randomized controlled trial to reveal whether patient navigators are useful in maintaining adherence to DMARDs over time.


Arthritis Care & Research

Link to the source:;jsessionid=D19432FA5B549DEB5FF8904969AA3BAD.f02t03

The original title of article:

Can patient navigators improve adherence to disease-modifying antirheumatic drugs? quantitative findings from the med assist pilot study


Candace H. Feldman et al.

Exploratory, Rheumatoid arthritis, Joints, DMARDs, Adherence, MMAS‐8, MHI‐5, Beliefs about Medicines Questionnaire, Brief Illness Perception Questionnaire, Oral
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