Ceranic, Jelena (58396768600)Jelena (58396768600)CeranicKisic Tepavcevic, Darija (57218390033)Darija (57218390033)Kisic TepavcevicPetronijevic, Milan (6602635159)Milan (6602635159)PetronijevicMilic, Marija (57202972248)Marija (57202972248)MilicCeranic, Milija (58548176900)Milija (58548176900)CeranicRancic, Nemanja (54941042300)Nemanja (54941042300)RancicRistic, Gorica (57196975326)Gorica (57196975326)Ristic2025-06-122025-06-122023https://doi.org/10.3390/medicina59081446https://www.scopus.com/inward/record.uri?eid=2-s2.0-85168755349&doi=10.3390%2fmedicina59081446&partnerID=40&md5=9fb040290d0a9512211f464467ee597fhttps://remedy.med.bg.ac.rs/handle/123456789/2588Introduction: Methotrexate (MTX) reduces rheumatoid arthritis activity and ameliorates the long-term functional status in these patients. To achieve this aim, patients need to take their medication regularly. Nevertheless, non-adherence to MTX still remains a considerable issue in the management of rheumatoid arthritis. Objective: This study aimed to estimate the adherence to methotrexate in patients with rheumatoid arthritis and to identify specific non-adherence risk factors. Methods: A cross-sectional study included 111 patients (mean age 56.2 ± 10.6 years, 78.4% female, and mean disease duration 6 years (3–13)). Three adherence self-assessment questionnaires were used: the Compliance-Questionnaire-Rheumatology (CQR19), the Medication Adherence Reports Scale (MARS-5), and the Visual Analogue Scale (VAS). We also collected demographic data, disease and treatment characteristics, and anxiety/depression estimation results (Hospital Anxiety and Depression Scale, HADS). Results: Adherence was identified in 48.6% of patients (COR19), 70.3% of patients (MARS-5), and 82.9% of patients (VAS questionnaire). All three questionnaires displayed a significant positive mutual correlation: CQR19 with MARS-5 and VAS (r = 0.364, r = 0.329, respectively, p < 0.001 for both) and between the VAS and MARS-5 scores (r = 0.496, p < 0.001). A significant positive prediction was shown for urban residence (0.347 (0.134–0.901), p = 0.030) using the MARS-5, female sex (0.264 (0.095–0.730), p = 0.010) according to the CQR19, and for a dose of methotrexate (0.881 (0.783–0.992), p = 0.036) using the VAS, while negative predictions were shown for comorbidity number (3.062 (1.057–8.874), p = 0.039) and depression (1.142 (1.010–1.293), p = 0.035) using the MARS-5 and for older age (1.041 (1.003–1.081), p = 0.034) according to the CQR19. The use of steroids was a significant positive predictor in all three questionnaires and remained an independent predictor for methotrexate adherence in the multivariate logistic regression. Conclusions: We showed non-adherence to methotrexate in a significant number of patients using all three questionnaires. Concomitant steroid therapy emerged as an independent positive predictor for adherence. © 2023 by the authors.adherencemethotrexatepredictionrheumatoid arthritisself-report questionnaires