Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature

Item does not contain fulltextAdherence to medication in patients with rheumatoid arthritis is low, varying from 30 to 80%. Improving adherence to therapy could therefore dramatically improve the efficacy of drug therapy. Although indicators for suboptimal adherence can be useful to identify nonadherent patients, and could function as targets for adherence-improving interventions, no indicators are yet found to be consistently and strongly related to nonadherence. Despite this, nonadherence behavior could conceptually be categorized into two subtypes: unintentional (due to forgetfulness, regimen complexity or physical problems) and intentional (based on the patient's decision to take no/less medication). In case of intentional nonadherence, patients seem to make a benefit-risk analysis weighing the perceived risks of the treatment against the perceived benefits. This weighing process may be influenced by the patient's beliefs about medication, the patient's self-efficacy and the patient's knowledge of the disease. This implicates that besides tackling practical barriers, clinicians should be sensitive to patient's personal beliefs that may impact medication adherence

Rethinking Hybridity, Interrogating Mixedness

This article discusses definitions and debates about the terms ‘hybridity’ and ‘mixedness’ across the natural and human and social sciences, including the work of the cultural theorist Homi Bhabha. Using the argonomic idea of homology, that refers to correspondences in both the quality and the states of a thing or phenomena, insights are offered into how we might think of the layers and processes of mixing that can be involved in the event of hybridity. This is particularly important because discussions of mixedness in the social sciences, and in everyday life, can run together different phenomena, strata, states, their sensual traits and their relative maturity or in/stabilities. In the process, different modalities of mixing can be subsumed or collapsed. The article also provides a summary of the key ideas and arguments made by contributors to the issue