University of Massachusetts Medical School Faculty Publications


Agreement between Rheumatologist and Patient-reported Adherence to Methotrexate in a US Rheumatoid Arthritis Registry

UMMS Affiliation

Department of Orthopedics and Physical Rehabilitation; Department of Medicine, Division of Rheumatology

Publication Date


Document Type



Musculoskeletal Diseases | Rheumatology


OBJECTIVE: Rheumatologists have limited tools to assess medication adherence. The extent to which methotrexate (MTX) adherence is overestimated by rheumatologists is unknown.

METHODS: We deployed an Internet survey to patients with rheumatoid arthritis (RA) participating in a US registry. Patient self-report was the gold standard compared to MTX recorded in the registry.

RESULTS: Response rate to the survey was 44%. Of 228 patients whose rheumatologist reported current MTX at the time of the most recent registry visit, 45 (19.7%) had discontinued (n = 19, 8.3%) or missed > /= 1 dose in the last month (n = 26, 11.4%). For the subgroup whose rheumatologist also confirmed at the next visit that they were still taking MTX (n = 149), only 2.6% reported not taking it, and 10.7% had missed at least 1 dose.

CONCLUSION: MTX use was misclassified for 13%-20% of patients, mainly because of 1 or more missed doses rather than overt discontinuation. Clinicians should be aware of suboptimal adherence when assessing MTX response.

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Citation: J Rheumatol. 2016 Jun;43(6):1027-9. doi: 10.3899/jrheum.151136. Epub 2016 May 1. Link to article on publisher's site

Related Resources

Link to Article in PubMed



Journal/Book/Conference Title

The Journal of rheumatology

PubMed ID