Patient and Caregiver Priorities for Medication Adherence in Gout, Osteoporosis, and Rheumatoid Arthritis: Nominal Group Technique

Ayano Kelly*, Kathleen Tymms, Maarten de Wit, Susan J. Bartlett, Marita Cross, Therese Dawson, Mary De Vera, Vicki Evans, Michael Gill, Geraldine Hassett, Irwin Lim, Karine Manera, Gabor Major, Lyn March, Sean O’Neill, Marieke Scholte-Voshaar, Premarani Sinnathurai, Daniel Sumpton, Armando Teixeira-Pinto, Peter TugwellBart van den Bemt, Allison Tong

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

20 Citations (Scopus)
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Objective: This study aimed to identify and prioritize factors important to patients and caregivers with regard to medication adherence in gout, osteoporosis (OP), and rheumatoid arthritis (RA) and to describe the reasons for their decisions. Methods: Patients with gout, OP, and RA and their caregivers, purposively sampled from 5 rheumatology clinics in Australia, identified and ranked factors that they considered important for medication adherence using nominal group technique and discussed their decisions. An importance score (IS; scale 0–1) was calculated, and qualitative data were analyzed thematically. Results: From 14 focus groups, 82 participants (67 patients and 15 caregivers) identified 49 factors. The top 5 factors based on the ranking of all participants were trust in doctor (IS 0.46), medication effectiveness (IS 0.31), doctor’s knowledge (IS 0.25), side effects (IS 0.23), and medication-taking routine (IS 0.13). The order of the ranking varied by participant groupings, with patients ranking “trust in doctor” the highest, while caregivers ranked “side effects” the highest. The 5 themes reflecting the reasons for factors influencing adherence were as follows: motivation and certainty in supportive individualized care; living well and restoring function; fear of toxicity and cumulative harm; seeking control and involvement; and unnecessarily difficult and inaccessible. Conclusion: Factors related to the doctor, medication properties, and patients’ medication knowledge and routine were important for adherence. Strengthening doctor–patient trust and partnership, managing side effects, and empowering patients with knowledge and skills for taking medication could enhance medication adherence in patients with rheumatic conditions.

Original languageEnglish
Pages (from-to)1410-1419
Number of pages10
JournalArthritis Care and Research
Issue number10
Early online date19 Jul 2019
Publication statusPublished - 1 Oct 2020


  • n/a OA procedure


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