{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T02:21:08Z","timestamp":1779330068246,"version":"3.51.4"},"reference-count":77,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,7,5]],"date-time":"2022-07-05T00:00:00Z","timestamp":1656979200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Health Planning &amp; Management"],"published-print":{"date-parts":[[2022,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate the effect of continuity of care on health outcomes (quality of life and functionality) in patients with rheumatoid arthritis and to reveal whether treatment adherence and disease activity have a serial multiple mediator role on this relationship.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study was cross\u2010sectional on 440 rheumatoid arthritis patients who applied to a university hospital rheumatology outpatient clinic. Research data were obtained from both the questionnaire method, which is the primary data source, and the patient files, which are the secondary data source. Process analysis was used in the analysis of the data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>It was found that the continuity of care has a direct effect on the quality of life and the functionality. In addition, it is seen that treatment adherence has a single partial mediator role on the relationship between continuity of care and quality of life; It has been determined that treatment adherence and disease activity have both partial single mediation and serial multiple mediation roles on the relationship between continuity of care and functionality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>It is thought that these findings will provide clinicians with important data and information in the management of rheumatoid arthritis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/hpm.3537","type":"journal-article","created":{"date-parts":[[2022,7,6]],"date-time":"2022-07-06T06:40:02Z","timestamp":1657089602000},"page":"3075-3088","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Serial multiple mediation of treatment adherence and disease activity in the relationship between continuity of care and health outcomes among rheumatoid arthritis patients"],"prefix":"10.1002","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0128-4001","authenticated-orcid":false,"given":"G\u00fclnur","family":"\u0130lg\u00fcn","sequence":"first","affiliation":[{"name":"Department of Health Care Management Faculty of Health Sciences Aksaray University  Aksaray Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2772-3033","authenticated-orcid":false,"given":"Bayram","family":"\u015eahin","sequence":"additional","affiliation":[{"name":"Department of Health Care Management Faculty of Economics and Administrative Sciences Hacettepe University  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,7,5]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Noncommunicable Diseases Progress Monitor 2020","author":"World Health Organization [WHO]","year":"2020"},{"key":"e_1_2_12_3_1","volume-title":"Diseases Country Profiles 2018","author":"WHO. Noncommunicable","year":"2018"},{"key":"e_1_2_12_4_1","volume-title":"Global Status Report on Noncommunicable Diseases 2010: Burden, Mortality, Morbidity and Risk Factors","author":"WHO","year":"2011"},{"key":"e_1_2_12_5_1","volume-title":"Turkey Household Health Survey: Prevalence of Risk Factors for Noncommunicable Diseases 2017","author":"\u00dcner S","year":"2018"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.318.7191.1090"},{"issue":"8","key":"e_1_2_12_7_1","first-page":"50","article-title":"Models of chronic disease management in primary care for patients with mild\u2010to\u2010moderate asthma or COPD: a narrative review","volume":"188","author":"Cranston JM","year":"2008","journal-title":"Med J Aust"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/1084822306289988"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61404-X"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7234.572"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-138-3-200302040-00034"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1370\/afm.649"},{"key":"e_1_2_12_13_1","unstructured":"American Academy of Family Physicians [AAFP].Continuity of Care Definition of [Internet]. Leawood (KS): American Academy of Family Physicians;1983.https:\/\/www.aafp.org\/about\/policies\/all\/continuity\u2010of\u2010care\u2010definition.html"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-197605000-00001"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.768986"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1053\/berh.2002.0257"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200826100-00004"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.5606\/ArchRheumatol.2018.6480"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/38.5.423"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.2165\/00019053-200119001-00001"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.61.9.818"},{"issue":"1","key":"e_1_2_12_22_1","first-page":"86","article-title":"Healthcare and burden of disease in psoriatic arthritis. A comparison with rheumatoid arthritis and ankylosing spondylitis","volume":"33","author":"Zink A","year":"2006","journal-title":"J Rheumatol"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780230202"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2002.004861"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.3109\/s10165-007-0604-9"},{"issue":"4","key":"e_1_2_12_26_1","first-page":"119","article-title":"Quality of life in patients with rheumatoid arthritis: relation with disease activity, functional and healt status","volume":"22","author":"Kaya T","year":"2007","journal-title":"Romatizma\/Rheumatism"},{"issue":"4","key":"e_1_2_12_27_1","first-page":"911","article-title":"Impact of fatigue on quality of life in patients with rheumatoid arthritis","volume":"29","author":"G\u00fcnayd\u0131n R","year":"2009","journal-title":"Turk Klinikleri J Med Sci"},{"issue":"3","key":"e_1_2_12_28_1","first-page":"334","article-title":"Impact of rheumatoid arthritis on quality of life, work productivity and resource utilisation: an observational, cross\u2010sectional study in Brazil","volume":"31","author":"Pinheiro GDRC","year":"2013","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-204311"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kew264"},{"key":"e_1_2_12_31_1","volume-title":"Master Thesis","author":"K\u0131l\u0131\u00e7 MC","year":"2015"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.23512"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1002\/anr.1790020103"},{"issue":"10","key":"e_1_2_12_34_1","first-page":"2114","article-title":"Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study","volume":"26","author":"Viller F","year":"1999","journal-title":"J Rheumatol"},{"issue":"3","key":"e_1_2_12_35_1","first-page":"337","article-title":"Medication adherence in rheumatoid arthritis: effects of psychosocial factors. Psychology","volume":"9","author":"Treharne GJ","year":"2004","journal-title":"Health & Medicine"},{"key":"e_1_2_12_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.24114"},{"key":"e_1_2_12_37_1","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.081204"},{"key":"e_1_2_12_38_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev105"},{"issue":"1","key":"e_1_2_12_39_1","first-page":"68","article-title":"Evaluation of adherence to drug treatment in patients with rheumatoid arthritis","volume":"4","author":"Alhefny AEA","year":"2016","journal-title":"Egypt J Rheumatol. Clin"},{"issue":"4","key":"e_1_2_12_40_1","first-page":"261","article-title":"Methods for measuring adherence to oral disease\u2010modifying drugs in rheumatoid arthritis and factors associated with low adherence to pharmacological treatment","volume":"25","author":"Rinc\u00f3n\u2010Rinc\u00f3n JR","year":"2018","journal-title":"Rev Colomb Reumatol"},{"key":"e_1_2_12_41_1","doi-asserted-by":"publisher","DOI":"10.15305\/ijrci\/v7i1\/316"},{"key":"e_1_2_12_42_1","doi-asserted-by":"publisher","DOI":"10.5606\/tftrd.2019.3071"},{"key":"e_1_2_12_43_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41927-019-0057-8"},{"key":"e_1_2_12_44_1","volume-title":"Continuity of Care in Type 2 Diabetes: Patients\u2019, Professionals\u2019 and Carers\u2019 Experiences and Health Outcomes","author":"Gulliford M","year":"2006"},{"key":"e_1_2_12_45_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-198601000-00007"},{"key":"e_1_2_12_46_1","doi-asserted-by":"publisher","DOI":"10.1345\/aph.10379"},{"key":"e_1_2_12_47_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1464-5491.2012.03733.x"},{"key":"e_1_2_12_48_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380107"},{"issue":"5","key":"e_1_2_12_49_1","first-page":"S93","article-title":"The disease activity score and the EULAR response criteria","volume":"23","author":"Fransen J","year":"2005","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_12_50_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.11407"},{"key":"e_1_2_12_51_1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/36.8.878"},{"key":"e_1_2_12_52_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200012)43:12<2751::AID-ANR15>3.0.CO;2-6"},{"key":"e_1_2_12_53_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20549"},{"key":"e_1_2_12_54_1","doi-asserted-by":"publisher","DOI":"10.1037\/0022-3514.51.6.1173"},{"issue":"1","key":"e_1_2_12_55_1","first-page":"42","article-title":"Statistical mediation analysis using the sobel test and Hayes SPSS process Macro","volume":"9","author":"Abu\u2010Bader S","year":"2021","journal-title":"Int. J Quant. Qual. Res. Methods"},{"key":"e_1_2_12_56_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression\u2010Based Approach","author":"Hayes AF","year":"2018"},{"key":"e_1_2_12_57_1","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2020.1787381"},{"issue":"4","key":"e_1_2_12_58_1","first-page":"505","article-title":"A multicenter cost\u2010of\u2010illness study on rheumatoid arthritis in Italy","volume":"20","author":"Leardini G","year":"2002","journal-title":"Clin Exp Rheumatol"},{"issue":"1","key":"e_1_2_12_59_1","first-page":"1","article-title":"Overview of rheumatoid arthritis: past lessons and future paths","volume":"1","author":"Lin SC","year":"2020","journal-title":"Curr Rheumatol Res"},{"key":"e_1_2_12_60_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.327.7425.1219"},{"key":"e_1_2_12_61_1","doi-asserted-by":"publisher","DOI":"10.1177\/1054773815625467"},{"key":"e_1_2_12_62_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph17239125"},{"key":"e_1_2_12_63_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8227(00)00198-4"},{"key":"e_1_2_12_64_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-016-1673-2"},{"issue":"12","key":"e_1_2_12_65_1","first-page":"16586","article-title":"Continuity of care for quality of life and clinical outcomes in patients with peritoneal dialysis","volume":"10","author":"Jiao Y","year":"2017","journal-title":"Int J Clin Exp Med"},{"key":"e_1_2_12_66_1","doi-asserted-by":"publisher","DOI":"10.1108\/JICA-04-2018-0033"},{"key":"e_1_2_12_67_1","doi-asserted-by":"publisher","DOI":"10.3390\/app9020268"},{"issue":"4","key":"e_1_2_12_68_1","first-page":"486","article-title":"Continuity of care and the quality of life among patients with type 2 diabetes mellitus: a cross\u2010sectional study in taiwan","volume":"8","author":"Hsieh PL","year":"2020","journal-title":"Health Care"},{"key":"e_1_2_12_69_1","doi-asserted-by":"publisher","DOI":"10.1111\/jep.12399"},{"key":"e_1_2_12_70_1","first-page":"194","article-title":"Study of health related quality of life in rheumatoid arthritis patients","volume":"9","author":"Sri Preethy NN","year":"2015","journal-title":"J Pharm Res"},{"key":"e_1_2_12_71_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejr.2016.11.004"},{"key":"e_1_2_12_72_1","doi-asserted-by":"publisher","DOI":"10.1186\/ar2620"},{"key":"e_1_2_12_73_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0206943"},{"key":"e_1_2_12_74_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(199909)42:9<1854::AID-ANR9>3.0.CO;2-F"},{"key":"e_1_2_12_75_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200002)43:2<386::AID-ANR19>3.0.CO;2-Z"},{"key":"e_1_2_12_76_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874312901307010058"},{"key":"e_1_2_12_77_1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2015-208669"},{"key":"e_1_2_12_78_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejr.2017.04.002"}],"container-title":["The International Journal of Health Planning and Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.3537","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/hpm.3537","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/hpm.3537","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,22]],"date-time":"2023-08-22T09:11:38Z","timestamp":1692695498000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/hpm.3537"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,5]]},"references-count":77,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,11]]}},"alternative-id":["10.1002\/hpm.3537"],"URL":"https:\/\/doi.org\/10.1002\/hpm.3537","archive":["Portico"],"relation":{},"ISSN":["0749-6753","1099-1751"],"issn-type":[{"value":"0749-6753","type":"print"},{"value":"1099-1751","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,5]]},"assertion":[{"value":"2022-01-25","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-06-19","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-05","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}