Psychological factors predict adherence to methotrexate in rheumatoid arthritis; findings from a systematic review of rates, predictors and associations with patient-reported and clinical outcomes.

Contreras-Yanez et al 24 reported that self-reported non-adherent patients who were in remission at baseline were more at risk of a disease flare than adherent patients during follow-up (48.41 per 100 person/years vs 13.31 per 100 person/years, p<0.002), the relative risk of non-adherence was borderline significant when adjusted for other factors (RR=4.8 (0.8 to 27.6), p=0.08).

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