medwireNews: Use of electronic monitoring feedback (EMF) may increase medication adherence in patients with rheumatoid arthritis (RA) who are initiating or switching to a new injected biologic DMARD, research shows.
During their 12-month study, Renske Hebing (Reade, Amsterdam, the Netherlands) and colleagues found that the mean medication possession ratio (MPR) was 0.95 among 104 individuals randomly assigned to an EMF intervention.
This was significantly higher than the mean MPR of 0.90 observed among the 102 individuals who received usual care.
The researchers explain that people in the intervention group were given a needle disposal container equipped with a medication event monitoring system cap that registered injection adherence.
Every 3 months, a pharmacist or pharmacy technician informed participants of their adherence scores and gave them motivational interviewing-based feedback. If patients were non-adherent (MPR <0.80) they were counseled on possible barriers to medication use.
In both groups, 76% of participants were initiating a biologic DMARD for the first time, with the remaining 24% switching from another biologic.
Hebing and co-authors report in RMD Open that more patients in the EMF group than in the control group were adherent to their medication when assessed using an MPR cutoff of 0.80, at 92% versus 85%.
But when adherence was measured using the Compliance Questionnaire in Rheumatology (CQR) Z score, the proportion adherent was lower in the intervention group than in the control group, at 67% versus 72%. Neither intragroup difference was statistically significant, however.
The investigators also found no significant difference in mean DAS28-ESR between the two groups at any time point and, overall, the intervention did not result in increased rates of low disease activity (LDA; DAS28-ESR 2.6–3.2) or remission (DAS28-ESR <2.6), or a reduced time to LDA or remission.
This lack of difference “might be due to selection bias, adequate usual care according to the treat to target paradigm and a too small sample size to detect the limited difference in adherence rates between groups,” Hebing et al remark.
And although there was no difference in time to LDA overall, the team did observe that, among participants who were biologic DMARD-naïve at baseline, those receiving EMF achieved LDA significantly earlier than those receiving usual care.
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