Factors associated with disease knowledge and medication adherence among rheumatoid arthritis patients attending a private rheumatology clinic: A cross-sectional study

Background: Rheumatoid arthritis (RA) is a chronic autoimmune disease that requires long-term pharmacotherapy and self-management. Disease knowledge and medication adherence are essential for achieving optimal outcomes, but remain under-researched in low-resource settings such as Nepal. Objective: This study aimed to assess the factors associated with disease knowledge and medication adherence among RA patients attending a private rheumatology clinic in Nepal. Design: Cross-sectional study. Methods: A hospital-based cross-sectional study was conducted from March to September 2023 among 428 RA patients who had been on a disease-modifying anti-rheumatic drugs (DMARDs) regimen for at least 3 months prior to the start of the study. Disease knowledge was assessed using the Rheumatoid Arthritis Knowledge Assessment Scale, and medication adherence was measured using the General Medication Adherence Scale. Pearson’s χ² test and multivariate logistic regression analyses were employed to examine the associations between levels of the disease knowledge, medication adherence, and related variables, using a 95% confidence interval and a 5% level of significance. Results: A total of 82.2% of RA patients had poor knowledge of the disease, and 62.2% demonstrated low medication adherence. Poor disease knowledge was significantly associated with older age, illiteracy, being a homemaker or unemployed, functional disability, higher disease activity, lower income, and absence of a family history of RA. Low medication adherence was significantly associated with male gender, being a homemaker or unemployed, rural residence, longer disease duration, presence of the comorbidities, obesity, higher disease activity, functional disability, and the use of multiple DMARDs. Conclusion: The findings highlight a critical gap in the disease knowledge and medication adherence among RA patients in Nepal, emphasizing the urgent need for targeted educational and adherence-enhancing interventions. Tailored strategies focusing on older adults, individuals with low literacy, and rural populations are essential to improve health outcomes and support effective RA management in resource-constrained settings.