University of Hertfordshire

  • Francesca Ometto
  • B. Raffeiner
  • D. Azzolina
  • C. Botsios
  • D. Astorri
  • John Done
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Original languageEnglish
Article numberCER11575
JournalClinical and Experimental Rheumatology
Journal publication date18 Mar 2019
Early online date18 Mar 2019
Publication statusE-pub ahead of print - 18 Mar 2019


Background The 5-item Compliance Questionnaire for Rheumatology (CQR5) allows the identification of patients likely be high adherers (HAs) to anti-rheumatic treatment, or “low” adherers (LAs), i.e. taking <80% of their medications correctly. The objective of the study was to validate the construct of an Italian version of CQR5 (I-CQR5) in rheumatoid arthritis (RA) patients and to investigate factors associated with high adherence. Methods RA patients, undergoing treatment with ≥1 self-administered bDMARD or csDMARD, were enrolled. The cross-cultural adaptation and validation of I-CQR5 followed standardised guidelines. I-CQR5 was completed by patients on one occasion. Data were subjected to Partial Credit model Parametrisation (PCM) to assess validity and reliability of I-CQR5. Analysis of factors associated with high adherence included demographic, social, clinical and treatment information. Factors achieving a p<0.10 in univariate analysis were included in multivariate analysis. Results Among 604 RA patients, 274 patients were included in the validation and 328 in the analysis of factors associated with adherence. Factor analysis and PCM confirmed the construct validity and consistency of I-CQR5. HAs were found to be 35.2% (109/310) of the patients. bDMARD treatment and employment were found to be independently associated with high adherence: OR 2.88 (1.36-6.1), p=0.006 and OR 2.36 (1.21-4.62), p=0.012 respectively. Conclusions Only one third of RA patients were HAs according to I-CQR5. bDMARDs and employment status increased by almost 3-fold the likelihood of being highly adherent to the anti-rheumatic treatment.

ID: 13716659