A critical review of compliance studies in rheumatoid arthritis

Nineteen studies of treatment compliance in rheumatoid arthritis (RA) patients have been critically appraised to assess the magnitude and determinants of noncompliance in this population. Deficiencies in study methodology undermined the possibility of firm conclusions on the influence of various factors on compliance in RA populations. Nevertheless, it is apparent that noncompliance with treatments for RA is a major problem that hitherto has not been widely considered. Compliance with prescribed drug regimens varied from 16% to 84% among these studies. With physiotherapy regimens, compliance rates varied from 39% to 65%, while for splint-usage, rates varied from 25% to 65%. No consistent correlation has been demonstrated between compliance and age, sex, treatment side effects, disease severity, or drug dose frequency. Gaps in our present day knowledge have been detailed and the need for further research is outlined.