In a recent study that evaluated whether patient navigators—laypersons trained in care coordination, motivational interviewing, basic pharmacology, and disease management—improved oral disease-modifying antirheumatic drug (DMARD) adherence, interventions resulted in no significant change in adherence from baseline. They enrolled 107 patients aged ≥18 years with systemic rheumatic diseases who initiated an oral DMARD within 6 months. Navigators interacted with patients up to 2 to 4 times per week for 6 months. Patients completed validated surveys (Morisky Medication Adherence Scale [MMAS-8], Mental Health Inventory [MHI-5], Beliefs about Medicines Questionnaire, and Brief Illness Perception Questionnaire) at baseline and at 6 months. Among total patients, 69 (64%) completed baseline and 6-month MMAS-8 surveys; mean age was 55 ±16 years; 93% were female. They found:
- The mean baseline MMAS-8 score was 6.7 ±1.3 (indicating borderline adherence), and the mean MHI-5 was 60.8 ± 9.1 (<68 suggests any depressive symptoms).
- After 6 months, there were no significant changes in MMAS-8 or MHI-5.
- Patients described fewer medication concerns, but a more threatening perception of illness.
Feldman CH, Wohlfahrt A, Campos A, et al. Can patient navigators improve adherence to disease-modifying antirheumatic drugs? Quantitative findings from the Med Assist Pilot Study. [Published online ahead of print June 2, 2017]. Arthritis Care Res. doi:10.1002/acr.23302.
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