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Therapeutic Drug Monitoring: Affecting Factors01:29

Therapeutic Drug Monitoring: Affecting Factors

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Therapeutic Drug Monitoring (TDM) is the clinical practice of measuring specific drug levels in a patient's blood or body tissues to manage and optimize therapy. TDM is crucial for drugs with narrow therapeutic windows, like warfarin and phenytoin, where incorrect doses can lead to treatment failure or severe side effects. This monitoring ensures the dosage administered is within a safe and effective range. The factors affecting therapeutic drug monitoring include:Patient-Specific Factors:a.
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Development of a Complex Biofeedback-Based Intervention to Improve Methotrexate Adherence in Rheumatoid Arthritis: A

Hannah Shafi1, Christopher J Armitage2, Suzanne M M Verstappen3,4

  • 1Versus Arthritis Centre for Genetics and Genomics, Centre for Musculoskeletal Research, the University of Manchester, Manchester, UK.

Patient Preference and Adherence
|March 5, 2026
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Summary
This summary is machine-generated.

Understanding methotrexate adherence in rheumatoid arthritis is key. This study identifies factors influencing patient adherence and informs the development of interventions to improve treatment outcomes.

Keywords:
biochemical adherencemethotrexatequalitative researchself-management

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Area of Science:

  • Rheumatology
  • Behavioral Science
  • Pharmacology

Background:

  • Methotrexate (MTX) is a primary treatment for Rheumatoid Arthritis (RA).
  • Sub-optimal patient adherence to MTX is a common challenge in RA management.
  • Current methods for assessing MTX adherence in clinical settings are limited.

Purpose of the Study:

  • To explore factors influencing MTX adherence in RA patients.
  • To inform the development of a behavior change intervention for MTX adherence.
  • To investigate how MTX biochemical adherence testing can be utilized to improve patient compliance.

Main Methods:

  • A qualitative study involving semi-structured telephone interviews with 17 RA patients on MTX.
  • Interviews guided by the Capability, Opportunity, and Motivation to Behavior (COM-B) model and Theoretical Domains Framework (TDF).
  • Inductive analysis of interview transcripts to identify themes related to MTX adherence.

Main Results:

  • Five key themes emerged: knowledge of MTX, motivators/barriers to continuation, healthcare approach, habit formation, and biochemical adherence testing.
  • Identified facilitators and barriers influencing methotrexate adherence in RA patients.
  • Explored patient perspectives on MTX biochemical adherence tests and external monitoring.

Conclusions:

  • Understanding patient capabilities, opportunities, and motivations is crucial for effective MTX adherence interventions.
  • Targeted behavior change techniques can be selected based on identified adherence factors.
  • This theory-driven approach offers a novel strategy to enhance the uptake and effectiveness of MTX adherence testing.