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Authors Li L, Cui Y, Yin R, Chen S, Zhao Q, Chen H, Shen B
Received 26 April 2017
Accepted for publication 7 July 2017
Published 4 August 2017 Volume 2017:11 Pages 1343—1356
DOI https://doi.org/10.2147/PPA.S140457
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Akshita Wason
Peer reviewer comments 3
Editor who approved publication: Dr Naifeng Liu
Objective: Disease activity of rheumatoid arthritis (RA) patients was often
measured by the 28-joint count disease activity score (DAS-28), which consists
of 28 swollen and tender joint counts, patient’s assessment of disease activity
(visual analog scale [VAS]) and erythrocyte sedimentation rate. C-reactive
protein was also used to measure disease activity in RA patients. The aim was
to explore the impact of medication adherence on disease activity in patients
with RA.
Methods: A systematic search was performed in major
electronic databases (PubMed, Web of Science, the Cochrane Library, CNKI, VIP
and Wan fang) to identify studies reporting medication adherence and disease
activity in RA patients. Results were expressed as mean difference (MD) and 95%
CI.
Results: A total of seven identified studies matched the
inclusion criteria, reporting on a total of 1,963 adult RA patients in the
analysis. The total score of DAS-28 was significantly lower in adherent
patients than in nonadherent subjects (MD =-0.42, 95% CI [-0.80, -0.03], P =0.03). Similarly, a significant
difference was observed between medication adherent and nonadherent groups in
erythrocyte sedimentation rate (MD =-7.39, 95% CI [-11.69, -3.08], P <0.01) and tender joint count
(MD =-1.29, 95% CI [-2.51, -0.06], P =0.04).
Interestingly, the results of the meta-analysis showed no significant
difference between medication adherent and nonadherent patients in swollen
joint count (MD =-0.16, 95% CI [-2.13, 1.80], P =0.87),
visual analog scale (MD =1.41, 95% CI [-3.68, 6.50], P =0.59) and C-reactive protein (MD
=0.35, 95% CI [-0.64, 1.34], P =0.49).
Conclusion: The study suggests that RA patients with higher
medication adherence tended to have lower disease activity.
Keywords: rheumatoid
arthritis, medication adherence, disease activity, meta-analysis