Development and content of a group-based intervention to improve medication adherence in non-adherent patients with rheumatoid arthritis

Patient Educ Couns. 2012 Oct;89(1):143-51. doi: 10.1016/j.pec.2012.07.007. Epub 2012 Aug 9.


Objective: To describe the systematic development and content of a short intervention to improve medication adherence to disease-modifying anti-rheumatic drugs in non-adherent patients with rheumatoid arthritis (RA).

Methods: The intervention mapping (IM) framework was used to develop the intervention. The following IM steps were conducted: (1) a needs assessment; (2) formulation of specific intervention objectives; (3) inventory of methods and techniques needed to design the intervention and (4) production and piloting of the intervention.

Results: The intervention (consisting of two group sessions led by a pharmacist, a homework assignment, and a follow-up call) aims to improve the balance between necessity and concern beliefs about medication, and to resolve practical barriers in medication taking. The central communication method used is motivational interviewing.

Conclusion: By applying the IM framework, we were able to create a feasible, time-efficient and promising intervention to improve medication adherence in non-adherent RA patients. Intervention effects are currently being assessed in a randomized controlled trial.

Practice implications: This paper could serve as a guideline for other health care professionals when developing similar interventions. If the RCT demonstrates sufficient effectiveness of this intervention in reducing medication non-adherence in RA patients, the intervention could be embedded in clinical practice.

MeSH terms

  • Adult
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / psychology*
  • Communication*
  • Cross-Sectional Studies
  • Focus Groups
  • Follow-Up Studies
  • Group Processes
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Medication Adherence / psychology*
  • Middle Aged
  • Motivational Interviewing*
  • Needs Assessment
  • Netherlands
  • Patient Satisfaction
  • Pharmacists
  • Program Development
  • Program Evaluation
  • Randomized Controlled Trials as Topic


  • Antirheumatic Agents