Table 1

Summary of the studies included in the SLR

AuthorConditionStudy designType of intervention/Adherence assessmentResult
RA91 patientsRCT, 6 months
  • Educational vs usual care

  • Pharmacological marker

At 6 months, 85% of the IG compared with 55% of the CG were taking their medication as prescribed (p<0.05)
RA122 patientsRCT, 6 months
  • Educational vs usual care

  • Morisky (MMAS-8)

At 6 months, 98% of the IG were adherent compared with 83% in the CG (p=0.0003)
Multiple chronic diseases including RA 379 patientsRCT, 1 month
  • Educational vs usual care

  • Patient report by phone

At 1 month, 91% of the IG were adherent compared with 84% in the CG (p=0.032)
SLE114 patientsRCT, 20 months
  • Educational vs usual care

  • Likert scale (10 items, max=20 points)

At 20 months, mean adherence score was 15.6 in the IG compared with 7.7 in the CG (p=0.033)
RA55 patientsRCT, 12 months
  • Educational vs usual care

  • Pharmacy data

No significant difference between IG and CG
RA77 patientsRCT, 12 months
  • Educational vs usual care

  • Morisky (MMAS-4)

No significant difference between IG and CG
RA108 patientsRCT, 1 month
  • Educational vs usual care

  • MAQ

No significant difference between IG and CG
RA and PsA62 patientsRCT
  • Individual education vs collective education

  • Patient self-report and pill counts

No significant difference between the two types of educational interventions
RA732 patientsLongitudinal cohort study, 6 months
  • Educational vs usual care

  • PDC

At 6 months, mean PDC was 89% in the IG compared with 60% in the CG (p<0.001)
Gout45 patientsSingle arm prospective non-controlled study, 12 months
  • Educational

  • Morisky (MMAS-4)

Morisky scores improved from median baseline score at 6 months and minimally further increased at 12 months
RA105 patientsNon-randomised controlled study, 5 months
  • Educational vs usual care

  • Morisky (MMAS)

No significant difference between website users and non users
SLE41 patientsRCT, 14 months
  • Behavioural vs usual care

  • Patient self-report, HCQ blood levels and pharmacy refill data

No significant difference between IG and CG
RA201 patientsProspective cohort study
  • Behavioural

  • CQR

Use of reminders was associated with better adhesion especially in situations at high risk to forget the treatment
RA59 patientsRCT, 12 months
  • Cognitive behavioural vs usual care

  • Self report (3 points scale)

At 12 months, significative increase in medication adherence in IG (p<0.05 baseline vs M12)Trend to decrease in medication adherence in CG (p=0.08)
RA234 patientsRCT, 12 months
  • Cognitive behavioural vs usual care

  • CQR, MARS and pharmacy refill data

No significant difference between IG and CG
RA18 patientsRCT, 3 months
  • Cognitive behavioural vs usual care

  • MARS and Morisky

No significant difference between IG and CG
RA and SLE59 patientsNon-randomised, non-controlled study, 6 months
  • Cognitive behavioural

  • Morisky (MMAS-8)

At 6 months, there were no significant change in MMAS-8
SLE714 patientsProspective non-controlled cohort study
  • Multicomponent

  • HCQ blood levels

Proportion of patients with HCQ blood levels > 500 ng/mL increased from 56% at baseline to 80% in patients who had 3 or more visits
RA166 patientsRCT, 6 months
  • Shared decision making vs usual care

  • Self report (validated single-item measure)

No significant difference between IG and CG
RA, PsA and chronic inflammatory bowel diseases 306 patientsCohort study, 6 months
  • Shared decision making vs usual care

  • Morisky (MMAS-4)

At 6 months, mean MMAS-4 was 0.17 in IG vs 0.41 in CG (p=0.001)
RA and SpA123 patientsNon-randomised study, 24 months
  • Shared decision making vs usual care (historical comparison group)

  • Morisky (MMAS-8)

No significant difference between IG and CG
Van den Bemt et al 201140 RA50 patientsProspective cohort study
  • Making the rheumatologist aware of patients’ non-adherence

  • CQR

Making the rheumatologist aware of patients’ non-adherence did not improve medication adherence
  • CG, control group; CQR, Compliance Questionnaire Rheumatology; HCQ, hydroxychloroquine; IG, intervention group; MARS, Medication Adherence Report Scale; MAQ, Medication Adhesion Questionnaire; MMAS, Morisky Medication Adherence Scale; PDC, proportion of days covered; PsA, psoriatic arthritis; RA, rheumatoid arthritis; RCT, randomised controlled trial; SLE, systemic lupus erythematosus; SLR, systematic literature review; SpA, spondyloarthritis .