Medication-Use Evaluation among Older Adults with Rheumatoid Arthritis in Lameue Village
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Page: 2523-2531
Abstract
Background: Rational medicine use is particularly important in older adults with rheumatoid arthritis (RA), who may face complex regimens, multimorbidity, and a greater risk of adverse drug events. Objective: To evaluate self-reported medication use and examine its associations with knowledge, adherence, and perceived clinical improvement among older adults with RA in Lameue Village, Pidie Regency. Methods: This cross-sectional correlational study included all 45 eligible older adults with RA in the study population (total sampling). Data were collected using a questionnaire reported as valid and reliable. Categorical variables were summarized as frequencies and percentages, and associations were explored using Pearson's chi-square test at a 5% significance level. Results: Medication-use evaluation was predominantly moderate (62.2%). Knowledge was poor in 40.0% of respondents; adherence was good in 35.6%, moderate in 28.9%, and poor in 35.6%. Perceived clinical improvement was moderate in 53.3%. Knowledge (p=0.002), adherence (p=0.024), and perceived clinical improvement (p<0.001) were associated with medication-use evaluation. Several expected cell counts were below five; therefore, the results should be interpreted as exploratory. Conclusion: Knowledge and adherence were associated with better self-reported medication-use evaluation. Structured education, caregiver involvement, medication review, and follow-up may support safer medicine use, but causal and clinical effectiveness claims require confirmation using validated outcomes and robust analyses.
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References
World Health Organization. Rheumatoid arthritis [Internet]. Geneva: WHO; 2023 [cited 2026 Aug 14]. Available from: https://www.who.int/news-room/fact-sheets/detail/rheumatoid-arthritis
Zou W, Xiao Z, Wen X, et al. Increasing global burden of rheumatoid arthritis: an epidemiological analysis from 1990 to 2019. Arch Med Sci. 2023;19(6):1707-1716. doi:10.5114/aoms/162629.
Smolen JS, Landewé RBM, Bergstra SA, et al. EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2022 update. Ann Rheum Dis. 2023;82(1):3-18. doi:10.1136/ard-2022-223356.
Suryana BPP, Hidayat R, Sarmidi S, et al. Characteristics and prevalence of clinical remission of rheumatoid arthritis in a nationwide study from Indonesia. Int J Rheum Dis. 2024;27(2):e15050. doi:10.1111/1756-185X.15050.
Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis. 2018;9(1):143-150. doi:10.14336/AD.2017.0306.
Erdem Sultanoğlu T. Medication adherence to pharmacological treatment and health literacy in patients with rheumatoid arthritis. Hosp Pract Res. 2024;9(2):456-461. doi:10.30491/hpr.2024.462336.1433.
Aksoy N, Ozturk N, Agh T, Kardas P. Adherence to antirheumatic drugs: a systematic review and meta-analysis. Front Med (Lausanne). 2024;11:1456251. doi:10.3389/fmed.2024.1456251.
Gorter A, Bakker MM, ten Klooster PM, et al. The impact of health literacy: associations with disease activity and medication prescription in patients with rheumatoid arthritis. Rheumatology (Oxford). 2023;62(10):3409-3415. doi:10.1093/rheumatology/kead052.
Asgari S, Abbasi M, Hamilton K, et al. A theory-based intervention to promote medication adherence in patients with rheumatoid arthritis: a randomized controlled trial. Clin Rheumatol. 2021;40(1):101-111. doi:10.1007/s10067-020-05224-y.
Jinno S, Onishi A, Hattori S, et al. Comparison of retention of biologics in Japanese patients with elderly-onset rheumatoid arthritis: the ANSWER cohort study. Rheumatology (Oxford). 2025;64(2):509-516. doi:10.1093/rheumatology/keae081.
Aletaha D, Neogi T, Silman AJ, et al. 2010 rheumatoid arthritis classification criteria: an American College of Rheumatology/European League Against Rheumatism collaborative initiative. Arthritis Rheum. 2010;62(9):2569-2581. doi:10.1002/art.27584.
Dey M, Budhathoki S, Elwell H, et al. Association of health literacy with disease outcomes in inflammatory arthritis: a systematic review. Ann Rheum Dis. 2025; published online Sep 11. doi:10.1016/j.ard.2025.08.018.
Truijen SPM, Schreurs JPR, Boonen A, van Onna M. The operational definition of old age and impact on outcomes in DMARD-treated patients with rheumatoid arthritis: a systematic literature review. Semin Arthritis Rheum. 2025;71:152607. doi:10.1016/j.semarthrit.2024.152607.
Smith ID, England BR, Pagidipati NJ, Bosworth H. Medication adherence in rheumatoid arthritis: implications for cardiovascular disease risk and strategies to address in U.S. veterans. Expert Rev Pharmacoecon Outcomes Res. 2025;25(4):473-485. doi:10.1080/14737167.2025.2451141.
Ahijón Lana M, Sivera Mascaró F, Fernández-Nebro A, et al. EducAR: implementing a multicomponent strategy to improve therapeutic adherence in rheumatoid arthritis. RMD Open. 2025;11(1):e004989. doi:10.1136/rmdopen-2024-004989.
Nikiphorou E, Santos EJF, Marques A, et al. 2021 EULAR recommendations for the implementation of self-management strategies in patients with inflammatory arthritis. Ann Rheum Dis. 2021;80(10):1278-1285. doi:10.1136/annrheumdis-2021-220249.
Marques A, Santos E, Nikiphorou E, Bosworth A, Carmona L. Effectiveness of self-management interventions in inflammatory arthritis: a systematic review informing the 2021 EULAR recommendations. RMD Open. 2021;7(2):e001647. doi:10.1136/rmdopen-2021-001647.
Gwinnutt JM, Wieczorek M, Balanescu A, et al. 2021 EULAR recommendations regarding lifestyle behaviours and work participation to prevent progression of rheumatic and musculoskeletal diseases. Ann Rheum Dis. 2023;82(1):48-56. doi:10.1136/annrheumdis-2021-222020.
Nagy G, Roodenrijs NMT, Welsing PMJ, et al. EULAR points to consider for the management of difficult-to-treat rheumatoid arthritis. Ann Rheum Dis. 2022;81(1):20-33. doi:10.1136/annrheumdis-2021-220973.
Lois P, López Pedraza L, Rodero M, et al. Emerging trends in nurse-led programs of care for management of patients with established rheumatoid arthritis: systematic literature review. Reumatol Clin (Engl Ed). 2023;19(10):579-592. doi:10.1016/j.reumae.2023.10.004.
Yajima N, Kawaguchi T, Takahashi R, et al. Adherence to methotrexate and associated factors considering social desirability in patients with rheumatoid arthritis: a multicenter cross-sectional study. BMC Rheumatol. 2022;6:75. doi:10.1186/s41927-022-00305-8.
Huang L, Zhou Y, Liu Y, Xu P, Deng X. Medication adherence and illness perception in patients with rheumatoid arthritis: the mediating effect of self-efficacy. J Musculoskelet Neuronal Interact. 2025;25(1):101-108. doi:10.22540/JMNI-25-101.