Objectives: To evaluate the effect of a musculoskeletal ultrasound programme (MUSP) applying real-time ultrasonography with reinforcement of findings by a rheumatologist on improving disease-modifying anti-rheumatic drugs (DMARDs) adherence in rheumatoid arthritis (RA).

Method: Eligible RA patients with low adherence score (< 6) on the 8-item Morisky Medication Adherence Scale (MMAS-8) were randomized to either an intervention group (receiving MUSP at baseline) or a control group (no MUSP), and followed up for 6 months. Adherence measures (patient-reported and pharmacy dispensing records) and clinical efficacy data were collected. The MUSP’s feasibility and acceptability were assessed.

Results: Among 132 recruited RA patients, six without baseline visits were excluded; therefore, 126 patients were analysed (62 intervention and 64 control). The primary outcome (proportion of patients with 1 month MMAS-8 score < 6) was significantly smaller (p = 0.019) in the intervention (35.48%) than the control group (56.25%). However, 3 and 6 month adherence and clinical efficacy outcomes were not significantly different between the two groups (all p > 0.05). All 62 patients completed the MUSP (mean time taken, 9.2 min), with the majority reporting moderately/very much improved understanding of their joint condition (71%) and the importance of regularly taking their RA medication(s) (79%). Most patients (90.3%) would recommend the MUSP to another RA patient.

Conclusions: The MUSP improved RA patients’ DMARDs adherence in the short term and was feasible and well accepted by patients. Future studies could evaluate whether repeated feedback using MUSP could help to sustain the improvement in DMARD adherence in RA patients, and whether this may be clinically impactful and cost-effective.

目的：评估肌肉骨骼超声计划 (MUSP) 应用实时超声检查并加强风湿病学家的发现对改善类风湿性关节炎 (RA) 中改善疾病的抗风湿药物 (DMARDs) 依从性的效果。

方法：符合条件的 RA 患者在 8 项 Morisky 药物依从性量表 (MMAS-8) 中依从性评分低 (< 6) 被随机分配到干预组（基线时接受 MUSP）或对照组（无 MUSP），并且随访6个月。收集依从性测量（患者报告和药房配药记录）和临床疗效数据。对 MUSP 的可行性和可接受性进行了评估。

结果：在招募的 132 名 RA 患者中，排除了 6 名没有基线就诊的患者；因此，分析了 126 名患者（62 名干预和 64 名对照）。干预组（35.48%）的主要结局（1个月MMAS-8评分<6的患者比例）明显小于对照组（56.25%）（p = 0.019）。然而，3 个月和 6 个月的依从性和临床疗效结果在两组之间没有显着差异（均 p > 0.05）。所有 62 名患者都完成了 MUSP（平均耗时 9.2 分钟），其中大多数患者报告对他们的关节状况 (71%) 和定期服用 RA 药物的重要性 (79%) 的了解适度/非常好。大多数患者 (90.3%) 会向另一名 RA 患者推荐 MUSP。

结论：MUSP在短期内提高了RA患者的DMARDs依从性，具有可行性，并被患者广泛接受。未来的研究可以评估使用 MUSP 的重复反馈是否有助于维持 RA 患者 DMARD 依从性的改善，以及这是否具有临床影响和成本效益。