Determinants of compliance in rheumatoid arthritic patients assessed in their home environment

Patient compliance with prescriber's medication instructions was investigated in 178 rheumatoid arthritis patients treated in community practice. The compliance rate in the sample subjects was estimated to be 63.5%. Disease activity, measured objectively with erythrocyte sedimentation rate (ESR) and subjectively by duration of morning stiffness, was a major incentive for adherence to the treatment regimen. Among subjects with active disease (ESR greater than 20 mm in 1 h), the rate of compliance was 73.8%, but this fell to 52.7% among those with a normal ESR (i.e. ESR less than or equal to 20 mm in 1 h). The motivations and perceptions of the subjects concerning their drug therapy also affected compliance. Compliance was however less dependent on perceptions when active inflammation was present.