Visit adherence and clinical, inflammatory, and patient-reported outcomes in rheumatoid arthritis: a cross-sectional...

This study examines how visit adherence influences disease activity, outcomes, and quality of life in rheumatoid arthritis, and suggests recommendations to improve management.

A toal of 216 RA patients diagnosed for at least 1 year were studied. Clinical and physical data were recorded at enrollment. Visit adherence was defined as attending at least 4 outpatient visits per year. Questionnaires (Patient Global, SF-36, HAQ, PUKI, HAD, MAF) and disease activity scores (DAS-28, SDAI, CDAI) were collected to assess associations with visit adherence.

Visit-adherent patients averaged 49.3 ± 14 years; non-adherent patients averaged 55.9 ± 14.7 years. Among women, 93 (70.5%) were adherent; among men, 39 (29.5%) were adherent. Age, gender, education, physical activity, and appointment type affected adherence. Adherence was associated with longer disease duration, delayed diagnosis, medication adherence, osteoporosis, morning stiffness, rheumatoid nodules, erosive joints, and high ESR and CRP (p < 0.001). Visit adherence is key to managing disease, improving outcomes, reducing complications, and improving quality of life.

This study demonstrates that patients with higher disease activity, greater inflammation, and clinical symptoms such as morning stiffness are more likely to struggle with adherence to visits. The findings suggest that targeted interventions-such as tailored education, reminders, flexible scheduling, and additional patient support-should be implemented to help these patients adhere to visits. Improving visit adherence may enhance treatment outcomes, reduce complications, and increase quality of life for these patients. Key Points • Low visit adherence in rheumatoid arthritis is associated with higher disease activity, increased inflammatory burden, and poorer quality of life. • Patients with visit non-compliance had significantly worse functional, psychological, and disease activity scores. • Improving regular follow-up adherence may contribute to better disease control and improved clinical outcomes in rheumatoid arthritis.