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Medication adherence has an impact on disease activity in rheumatoid arthritis: a systematic review and meta-analysis

机译：药物依从性对类风湿关节炎疾病活动的影响：系统评价和荟萃分析

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Objective: Disease activity of rheumatoid arthritis (RA) patients was often measured by the 28-joint count disease activity score (DAS-28), which consists of 28 swollen and tender joint counts, patient’s assessment of disease activity (visual analog scale [VAS]) and erythrocyte sedimentation rate. C-reactive protein was also used to measure disease activity in RA patients. The aim was to explore the impact of medication adherence on disease activity in patients with RA. Methods: A systematic search was performed in major electronic databases (PubMed, Web of Science, the Cochrane Library, CNKI, VIP and Wan fang) to identify studies reporting medication adherence and disease activity in RA patients. Results were expressed as mean difference (MD) and 95% CI. Results: A total of seven identified studies matched the inclusion criteria, reporting on a total of 1,963 adult RA patients in the analysis. The total score of DAS-28 was significantly lower in adherent patients than in nonadherent subjects (MD =-0.42, 95% CI [-0.80, -0.03], P =0.03). Similarly, a significant difference was observed between medication adherent and nonadherent groups in erythrocyte sedimentation rate (MD =-7.39, 95% CI [-11.69, -3.08], P <0.01) and tender joint count (MD =-1.29, 95% CI [-2.51, -0.06], P =0.04). Interestingly, the results of the meta-analysis showed no significant difference between medication adherent and nonadherent patients in swollen joint count (MD =-0.16, 95% CI [-2.13, 1.80], P =0.87), visual analog scale (MD =1.41, 95% CI [-3.68, 6.50], P =0.59) and C-reactive protein (MD =0.35, 95% CI [-0.64, 1.34], P =0.49). Conclusion: The study suggests that RA patients with higher medication adherence tended to have lower disease activity.
机译：目的：类风湿关节炎（RA）患者的疾病活动通常通过28个关节计数疾病活动评分（DAS-28）来衡量，该评分包括28个肿胀和压痛的关节计数，患者对疾病活动的评估（视觉模拟评分[VAS ]）和红细胞沉降率。 C反应蛋白也被用于测量RA患者的疾病活动。目的是探讨药物依从性对RA患者疾病活动的影响。方法：在主要的电子数据库（PubMed，Web of Science，Cochrane图书馆，CNKI，VIP和万方）中进行系统搜索，以鉴定报告RA患者药物依从性和疾病活动的研究。结果表示为平均差异（MD）和95％CI。结果：共有7项确定的研究符合纳入标准，报告分析中共有1963名成年RA患者。依从性患者中DAS-28的总得分显着低于非依从性患者（MD = -0.42，95％CI [-0.80，-0.03]，P = 0.03）。同样，药物依从组和非药物依从组之间的红细胞沉降率（MD = -7.39，95％CI [-11.69，-3.08]，P <0.01）和压痛关节计数（MD = -1.29，95％）之间存在显着差异。 CI [-2.51，-0.06]，P ＝ 0.04）。有趣的是，荟萃分析的结果显示，依从性和非依从性的患者在关节肿胀（MD = -0.16，95％CI [-2.13，1.80]，P = 0.87），视觉模拟量表（MD = 1.41、95％CI [-3.68，6.50]，P = 0.59）和C反应蛋白（MD = 0.35，95％CI [-0.64，1.34]，P = 0.49）。结论：该研究表明，具有较高药物依从性的RA患者往往具有较低的疾病活动性。

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