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Adherence to methotrexate in rheumatoid arthritis: a danish nationwide cohort study.

Bliddal H, Eriksen SA, Christensen R, Lorenzen T, Hansen MS, Østergaard M, Dreyer L, Luta G, Vestergaard P - Arthritis (2015)

Bottom Line: Conclusions.Treatment at hospital or in private practice did not influence the adherence to MTX.Nonmodifiable factors of importance were gender and age, while adherence to MTX therapy decreased with time lapse between diagnosis and prescription.

View Article: PubMed Central - PubMed

Affiliation: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital at Bispebjerg and Frederiksberg, 2000 Copenhagen F, Denmark ; Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Aalborg University, 9220 Aalborg, Denmark.

ABSTRACT
Objectives. To study adherence to methotrexate (MTX) and factors of importance thereof in patients with rheumatoid arthritis (RA). Methods. Patients with a hospital diagnosis of RA (ICD10 codes M05.X or M06.X) after January 1, 1997, and aged ≥18 years at the date of first diagnosis/contact, with at least one prescription of MTX (L04AX03), were included. Results. A total of 18,703 (47.6%) patients had ever used MTX among 39,286 with a diagnosis of RA; among the MTX users, 16,503 (88.2%) had filed more than one MTX prescription. The median time from diagnosis to first MTX prescription was 0.66 (IQR 0.26-1.80) years. In those who filed more than one MTX prescription, the mean adherence time for ≥7.5 mg MTX per week was 1,925 (IQR 467-3,056) days for patients treated in private practice versus 1,892 (IQR 452-3,316) days for patients treated in hospital. The main determinants of nonadherence were female gender, younger age, and time from diagnosis to initiation of MTX. Conclusions. Treatment at hospital or in private practice did not influence the adherence to MTX. Nonmodifiable factors of importance were gender and age, while adherence to MTX therapy decreased with time lapse between diagnosis and prescription.

No MeSH data available.


Related in: MedlinePlus

Study population (flow diagram). The study period began January 1, 1997. However, to exclude prevalent cases, only those with a de novo diagnosis after January 1, 1998, were included.
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Related In: Results  -  Collection


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fig1: Study population (flow diagram). The study period began January 1, 1997. However, to exclude prevalent cases, only those with a de novo diagnosis after January 1, 1998, were included.

Mentions: Figure 1 shows the sampling profile among inhabitants in Denmark: from the 5.4 million eligible inhabitants, 4.1 million were aged 18 years or more, and of these 39,286 had had a diagnosis of RA, and among these a little less than half of them (18,703; 47.6%) had ever filed a prescription for MTX. Due to the extensive nature of the registers, all could be followed until time of death, migration, or December 31, 2012, whichever came first. Table 1 shows the characteristics of the participants and information on exposures and potential confounders. Comorbid conditions were scarce—most numbering a few per cent.


Adherence to methotrexate in rheumatoid arthritis: a danish nationwide cohort study.

Bliddal H, Eriksen SA, Christensen R, Lorenzen T, Hansen MS, Østergaard M, Dreyer L, Luta G, Vestergaard P - Arthritis (2015)

Study population (flow diagram). The study period began January 1, 1997. However, to exclude prevalent cases, only those with a de novo diagnosis after January 1, 1998, were included.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4355606&req=5

fig1: Study population (flow diagram). The study period began January 1, 1997. However, to exclude prevalent cases, only those with a de novo diagnosis after January 1, 1998, were included.
Mentions: Figure 1 shows the sampling profile among inhabitants in Denmark: from the 5.4 million eligible inhabitants, 4.1 million were aged 18 years or more, and of these 39,286 had had a diagnosis of RA, and among these a little less than half of them (18,703; 47.6%) had ever filed a prescription for MTX. Due to the extensive nature of the registers, all could be followed until time of death, migration, or December 31, 2012, whichever came first. Table 1 shows the characteristics of the participants and information on exposures and potential confounders. Comorbid conditions were scarce—most numbering a few per cent.

Bottom Line: Conclusions.Treatment at hospital or in private practice did not influence the adherence to MTX.Nonmodifiable factors of importance were gender and age, while adherence to MTX therapy decreased with time lapse between diagnosis and prescription.

View Article: PubMed Central - PubMed

Affiliation: The Parker Institute, Department of Rheumatology, Copenhagen University Hospital at Bispebjerg and Frederiksberg, 2000 Copenhagen F, Denmark ; Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), Aalborg University, 9220 Aalborg, Denmark.

ABSTRACT
Objectives. To study adherence to methotrexate (MTX) and factors of importance thereof in patients with rheumatoid arthritis (RA). Methods. Patients with a hospital diagnosis of RA (ICD10 codes M05.X or M06.X) after January 1, 1997, and aged ≥18 years at the date of first diagnosis/contact, with at least one prescription of MTX (L04AX03), were included. Results. A total of 18,703 (47.6%) patients had ever used MTX among 39,286 with a diagnosis of RA; among the MTX users, 16,503 (88.2%) had filed more than one MTX prescription. The median time from diagnosis to first MTX prescription was 0.66 (IQR 0.26-1.80) years. In those who filed more than one MTX prescription, the mean adherence time for ≥7.5 mg MTX per week was 1,925 (IQR 467-3,056) days for patients treated in private practice versus 1,892 (IQR 452-3,316) days for patients treated in hospital. The main determinants of nonadherence were female gender, younger age, and time from diagnosis to initiation of MTX. Conclusions. Treatment at hospital or in private practice did not influence the adherence to MTX. Nonmodifiable factors of importance were gender and age, while adherence to MTX therapy decreased with time lapse between diagnosis and prescription.

No MeSH data available.


Related in: MedlinePlus