Skip to main content

Advertisement

SpringerLink
Log in

Adherence to treatment in patients with ankylosing spondylitis

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

This study aims to determine the level of adherence to treatment in ankylosing spondylitis (AS) patients and to identify possible factors associated to lack of adherence. We included consecutive AS patients (NY modified criteria). Sociodemographic and clinical data were collected. Patients answered auto-reported questionnaires: Bath Ankylosing Spondylitis Disease Activity Index, Bath Ankylosing Spondylitis Functional Index, Ankylosing Spondylitis Quality of Life, and Center for Epidemiological Studies Depression scale. Patients with rheumatoid arthritis (RA) (ACR’87 criteria) were assessed as the control group. The adherence of the studied groups to medical treatment and exercises was measured by means of two questionnaires: Compliance Questionnaire on Rheumatology (CQR) and Exercise Attitude Questionnaire-18 (EAQ-18). The study included 59 patients with AS and 53 patients with RA. Of the AS patients, 43 (72.9 %) were male, median age 47 years (interquartile range (IQR) 33–57) and median disease duration of 120 months (IQR 33–57). Of the RA patients, 37 (69.8 %) were female, had a median age of 56 years (IQR 43.5–60) and a median disease duration of 156 months (IQR 96–288). There were no significant differences in the results of the adherence questionnaires between both groups, with a total median of 68.42 for the CQR in both groups and of 40.7 in AS vs. 42.6 in RA for the EAQ. When dichotomizing patients as adherent and non-adherent, taking as good adherence a cut value in the CQR and EAQ higher than 60, adherence to pharmacological treatment was significantly higher in RA vs. AS (92.5 vs. 74.6 %, p = 0.01) and there were no differences in the EAQ. On the uni- and multivariate analysis, lack of adherence to treatment was not associated to sex, age, disease duration, education, health insurance, depressive status, and disease activity parameters in neither group of patients. AS have an acceptable adherence to pharmacological treatment, although it is lower than RA patients; nonetheless, both groups show a lack of adherence to exercise.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Gran JT, Skomsvoll JF (1997) The outcome of ankylosing spondylitis: a study of 100 patients. Br J Rheumatol 24:908–911

    Google Scholar 

  2. van der Linden S, van der Heijde D (1998) Ankylosing spondylitis. Clinical features. Rheum Dis Clin North Am 24:663–673

    Article  PubMed  Google Scholar 

  3. Brophy S, Mackay K, Al-Saidi A, Taylor G, Calin A (2002) The natural history of ankylosing spondylitis as defined by radiological progression. J Rheumatol 29:1236–1243

    PubMed  Google Scholar 

  4. Ward MM (1998) Quality of life in patients with ankylosing spondylitis. Rheum Dis Clin North Am 24:815–826

    Article  PubMed  CAS  Google Scholar 

  5. Ward MM, Weisman M, Davis JC Jr, Reveille JD (2005) Risk factors for functional limitations in patients with long-standing ankylosing spondylitis. Arthritis Rheum (Arthritis Care Res) 53:710–717

    Article  Google Scholar 

  6. Dougados M, Baeten D (2011) Spondyloarthritis. Lancet 377(9783):2127–2137

    Article  PubMed  Google Scholar 

  7. Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353:487–497

    Article  PubMed  CAS  Google Scholar 

  8. de Klerk E, van der Heijde D, Landewé R, van der Tempel H, van der Linden S (2003) The compliance-questionnaire-rheumatology compared with electronic medication event monitoring: a validation study. J Rheumatol 30(11):2469–2475

    PubMed  Google Scholar 

  9. Dagfinrud H, Halvorsen S, Vollestad NK, Niedermann K, Kvien TK, Hagen KB (2011) Exercise programs in trials for patients with ankylosing spondylitis: do they really have the potential for effectiveness? Arthritis Care Res (Hoboken) 63(4):597–603

    Article  Google Scholar 

  10. Gross M, Brabdt KD (1981) Educational support groups of patients with ankylosing spondylitis: a preliminary report. Patient Couns Health Educ 3(1):6–12

    Article  PubMed  CAS  Google Scholar 

  11. Manigandan C, Charles J, Divya I, Edward SJ, Aaron A (2004) Construction of exercise attitude questionnaire-18 to evaluate patients’ attitudes toward exercises. Int J Rehabil Res 27(3):229–231

    Article  PubMed  CAS  Google Scholar 

  12. Barlow JH, Macey SJ, Struthers GR (1993) Health locus of control, self-help and treatment adherence in relation to ankylosing spondylitis patients. Patient Educ Couns 20(2–3):153–166

    Article  PubMed  CAS  Google Scholar 

  13. De Klerk E, van der Linden SJ (1996) Compliance monitoring of NSAID drug therapy in ankylosing spondylitis experiences with an electronic monitoring device. Br J Rheumatol 35:60–65

    Article  PubMed  Google Scholar 

  14. van der Linden S, Valkenburg HA, Cats A (1984) Evaluation of diagnostic criteria for ankylosing spondylitis: a proposal for the modification of the New York criteria. Arthritis Rheum 27:361–368

    Article  PubMed  Google Scholar 

  15. Citera G, Maldonado Cocco JA, Moroldo M, et al. (1999) Validación de la versión en español de los cuestionarios de capacidad funcional BASFI y actividad de la enfermedad BASDAI en pacientes con Espondilitis Aquilosante en cuatro países Latinoamericanos. Rev Arg Reumatol (abstract-P 033). CONAR

  16. Marengo MF, Citera G, Schneeberger EE, Maldonado Cocco JA (2008) Work status among patients with ankylosing spondylitis in Argentina. J Clin Rheumatol 14:273–277

    Article  PubMed  Google Scholar 

  17. Arnett FC, Edworthy SM, Bloch DA et al (1987) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31:315–324

    Article  Google Scholar 

  18. Citera G, Arriola MS, Maldonado-Cocco JA et al (2004) Validation and crosscultural adaptation of an Argentine Spanish Version of the Health Assessment Questionnaire Disability Index. J Clin Rheumatol 10:110–115

    Article  PubMed  Google Scholar 

  19. Bart JF, van den Bemt BJ, van den Hoogen FH, Benraad B, Hekster YA, van Riel PL, van Lankveld W (2009) Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease modifying antirheumatic drugs. J Rheumatol 36(10):2164–2170

    Article  Google Scholar 

  20. Doyle DV, Perrett D, Foster OJ, Ensor M, Scott DL (1993) The long-term use of D-penicillamine for treating rheumatoid arthritis: is continuous therapy necessary? Br J Rheumatol 32:614–617

    Article  PubMed  CAS  Google Scholar 

  21. Pullar T, Peaker S, Martin MF, Bird HA, Feely MP (1988) The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy. Br J Rheumatol 27:381–384

    Article  PubMed  CAS  Google Scholar 

  22. Brus H, van de Laar M, Taal E, Rasker J, Wiegman O (1999) Determinants of compliance with medication in patients with rheumatoid arthritis: the importance of self-efficacy expectations. Patient Educ Couns 36:57–64

    Article  PubMed  CAS  Google Scholar 

  23. Kraag G, Stokes B, Groh J, Hehewa A, Goldsmith C (1990) The effects of comprehensive home physiotherapy and supervision on patients with ankylosing spondylitis—a randomized controlled trial. J Rheumatol 17(2):228–233

    PubMed  CAS  Google Scholar 

  24. Durmus D, Alayliu G, Cil E, Canturk F (2009) Effects of a home-based exercise program on quality of life, fatigue and depression in patients with ankylosing spondylitis. Rehumatol Int 29(6):673–677

    Article  Google Scholar 

  25. Karapolat H, Eyigor S, Zoghi M, Akkoc Y, Kirazli Y, Keser G (2009) Are swimming or aerobic exercise better than conventional exercise in ankylosing spondylitis patients? A randomized controlled study. Eur J Phys Rehabil Med 45(4):449–457

    PubMed  CAS  Google Scholar 

  26. Gyurcsik ZN, András A, Bodnár N, Szekanecz Z, Szántó S (2012) Improvement in pain intensity, spine stiffness, and mobility during a controlled individualized physiotherapy program in ankylosing spondylitis. Rheumatol Int 32(12):3931–3936

    Article  PubMed  Google Scholar 

Download references

Disclosures

None.

Author information

Authors and Affiliations

  1. Section of Rheumatology, Instituto de Rehabilitación Psicofísica, Echeverría 955, Buenos Aires, Argentina, 1428

    Pablo Arturi, Emilce Edith Schneeberger, Fernando Sommerfleck, Emilio Buschiazzo, César Ledesma, José Antonio Maldonado Cocco & Gustavo Citera

Authors
  1. Pablo Arturi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Emilce Edith Schneeberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fernando Sommerfleck
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emilio Buschiazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. César Ledesma
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. José Antonio Maldonado Cocco
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Gustavo Citera
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Gustavo Citera.

Appendices

Appendix 1

Appendix 1 (English version)

figure a

Appendix 1 (Spanish version)

figure b

Appendix 2

Appendix 2 (English version)

figure c

Appendix 2 (Spanish version)

figure d

Rights and permissions

Reprints and permissions

About this article

Cite this article

Arturi, P., Schneeberger, E.E., Sommerfleck, F. et al. Adherence to treatment in patients with ankylosing spondylitis. Clin Rheumatol 32, 1007–1015 (2013). https://doi.org/10.1007/s10067-013-2221-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-013-2221-7

Keywords

Search

Navigation