•  
  •  
 

Abstract

Background: Methotrexate (MTX) and other disease-modifying antirheumatic medications are necessary for the long-term management of rheumatoid arthritis (RA), a chronic autoimmune illness. Nonetheless, a significant obstacle in the treatment of RA continues to be non-adherence to MTX. Comprehending the behavioral elements linked to adherence could potentially enhance therapy results.
Objective: To assess MTX adherence using the CQR-19 and examine its association with behavioral factors among RA patients at Marjan Teaching Hospital.
Methods: A cross-sectional study was conducted in the Rheumatology Unit of Marjan Teaching Hospital, Babylon, Iraq, from December 18, 2025, to April 18, 2026. A total of 220 RA patients receiving long-term MTX therapy were recruited. Data were collected using the CQR-19 questionnaire, which was validated by a panel of five experts.
Results: Based on CQR-19 scores, 71% (n = 157) of patients were classified as non-adherent, while 29% (n = 63) were adherent. No significant associations were observed between adherence and age (P = 0.669), sex (P = 0.150), employment status (P = 0.187), or marital status (P = 0.784). In contrast, adherence was significantly associated with behavioral factors. Pain relief was the most frequently reported facilitator of MTX use (58.6%), whereas forgetfulness was the most common reason for missed doses (25.5%).
Conclusions: A high prevalence of MTX non-adherence was identified among Iraqi RA patients attending Marjan Teaching Hospital. Adherence was more strongly influenced by behavioral factors, particularly forgetfulness and perceived pain relief, than by demographic characteristics. Behavioral counseling and reminder-based interventions may improve adherence and should be incorporated into routine RA management.

First Page

185

Last Page

191

Download

Share

COinS