Towards a better understanding of reasons for non-adherence to treatment among patients with rheumatoid arthritis: A focus group study

Objective: To explore common reasons for non-adherence to treatment in patients with rheumatoid arthritis in Singapore.Methods: Patients diagnosed with rheumatoid arthritis for ⩾ 1 year being followed up at the Singapore General Hospital and meeting pre-defined criteria of non-adherence were invited to participate in focus groups to discuss issues related to adherence to their rheumatoid arthritis treatment. Each focus group was homogenous in terms of gender, language spoken and ethnicity. Discussions were audio recorded and subsequently transcribed verbatim for thematic analysis.Results: Of the 26 patients who participated in the study, seven reported non-adherence to medication, two reported non-adherence to doctors’ appointments, and 11 reported non-adherence to both. The most commonly mentioned reasons for non-adherence were forgetfulness ( n=13), low perceived need for treatment ( n=10), actual or perceived medication side effects ( n=6) and intentional delay due to busyness ( n=4). Eleven participants acknowledged more than one of these four reasons for non-adherence.Conclusion: There are multiple reasons for non-adherence to treatment among patients with rheumatoid arthritis in Singapore. Findings from this study provide important empirical evidence to inform strategies to improve adherence and in turn treatment outcomes for this group of patients in Singapore.