Medication adherence and predictive factors among patients with rheumatoid arthritis: A COM-B model guided structural equation modeling analysis

Abstract

ObjectiveTo assess medication adherence of patients with rheumatoid arthritis (RA) and explore predictive factors under the guidance of the Capability, Opportunity and Motivation to Behavior (COM-B) model. MethodsA cross-sectional study was conducted among 221 RA patients conveniently recruited from rheumatology outpatient clinics of a university-affiliated hospital in China. Data about patients’ sociodemographic and disease characteristics, medication adherence, functional disability, social support, beliefs about medicines, self-efficacy, and depression were collected via self-administered questionnaires. The influence of factors within the COM-B model on medication adherence were analyzed by the structural equation model. ResultsThe mean score of medication adherence was 63.19 (SD 8.83), and 214 participants (96.8%) were considered non-adherent to their medication regime. Greater functional disability, higher social support, more positive beliefs about medicines, higher self-efficacy, and lower depression were significantly positively associated directly or indirectly with medication adherence, explaining 66% of the total variance. ConclusionPatients with RA demonstrate poor medication adherence. Essentials in improving medication adherence are delaying the occurrence of disability, promoting social support, shaping beliefs about medicines, enhancing self-efficacy, and relieving depression. Practice ImplicationsThe value of integrated interventions targeting the drivers and barriers to medication adherence identified in this study should be further explored.