THU0623 FACTORS RELATED TO NON-ADHERENCE BEHAVIORS OF PATIENTS WITH RHEUMATIC DISEASES
Authors: L María, García Vivar, Javier de Toro-Santos, Lucía Pantoja, Cristina Lerín Lozano, Silvia García-Díaz, Sabela Fernández, Yvonne Mestre, Lidia Feo-Lucas, Luis Cea-Calvo
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Non-adherence to medication may lead to poorer clinical outcomes and should be prevented. <h3>Objectives</h3> We describe the frequency of non-adherence behaviors in patients with rheumatic diseases and its relationship to potentially modifiable variables. <h3>Methods</h3> Data were obtained through an anonymous survey handed to patients by physicians or nurses from 25 rheumatology clinics from Spain. Patients completed the survey anonymously at home and returned it by pre-paid post mail. Five different non-adherence behaviors were defined. Co-variables analyzed were patients' demographics, medication characteristics, experience with healthcare (assessed with IEXPAC "<i>Instrument to Evaluate the EXperience of PAtients with Chronic diseases</i>" scoring 0 [worst] to 10 [best experience]), and beliefs in medicines (Beliefs About Medicines Questionnaire [BMQ], composed of a necessity and a concerns subscales and scoring -20 [weaker] to +20 [stronger beliefs]). Variables associated to non-adherence were studied with a multivariate logistic regression model. <h3>Results</h3> The survey was handed to 625 patients with rheumatic diseases, of which 336 (53.8%) returned it with the necessary data completed (mean age 55 [14] years, 64% women). Of them, 188 (56.0%) described at least one non-adherence behavior. The frequencies of the specific non-adherence behaviors were: 1) Forgetfulness in taking medication: 28.6%; 2) Taking medication at unscheduled hours: 5.6%; 3) Stopping medication when feeling well: 10.1%; 4) Stopping medication when feeling sick: 33.0% and 5) Stopping medication after reading the patients' information leaflet: 11.5%. The frequency of at least one non-adherence behavior was similar by age, gender, educational level, working status or by number of medicines. It was slightly higher in patients needing to take their medication 3-4 times a day (63.2%) versus 1-2 times a day (52.4%, p= 0.089). IEXPAC scores were similar in patients with or without non-adherence behaviors (5.5 [2.0] in both groups, p= 0.960). BMQ overall score was lower in patients with non-adherence behaviors (4.3 versus 6.5 in those without non-adherence behaviors, p= 0.001). The frequency of non-adherence behaviors did not differ by quartiles of IEXPAC score, but it was higher in patients with lower BMQ score (Q1: 59.5%, Q2: 65.9%, Q3: 54.3%, Q4: 52.0%, p-trend = 0.014). The multivariate model (table) confirmed a relationship of non-adherence behaviors with lower BMQ beliefs scores. <h3>Conclusion</h3> Non-adherence behaviors are frequent in patients with rheumatic diseases and are mainly associated to patients' beliefs in their medications (assessed with BMQ). This is an important aspect that can be addressed by clinical teams to improve adherence and clinical outcomes. <b>Acknowledgement:</b> Funded by Merck Sharp &amp; Dohme of Spain and endorsed by 4 patients associations: ACCU, CONARTRITIS, SEISIDA, FEDE. <h3>Disclosure of Interests</h3> María L. García Vivar: None declared, Javier de Toro-Santos: None declared, Lucía Pantoja: None declared, Cristina Lerín Lozano: None declared, Silvia García-Díaz: None declared, Sabela Fernández Employee of: MSD, Yvonne Mestre Employee of: MSD, Lidia Feo-Lucas Employee of: MSD, Luis Cea-Calvo Employee of: MSD