THU0176 COMPARISON OF ADHERENCE TO MONOTHERAPY VERSUS COMBINED THERAPY IN RHEUMATOID ARTHRITIS
Authors: Iván de Jesús Hernández-Galarza, Dionicio Ángel Galarza-Delgado, Marielva Castro-González, Rita Pineda-Sic, Miguel Angel Villarreal-Alarcón, Octavio Ilizaliturri Guerra, Rodolfo Allan Uriarte Botello
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Treatment adherence in Rheumatoid Arthritis (RA) patients vary from 30 to 80% (1). It is important to identify the associated factors to a low adherence, so clinicians can make interventions to obtain better therapeutic results. Adherence to treatment has been described to be affected by several factors, such as access to healthcare facilities, education, socioeconomic status, quality of communication between physician and patient, among others (2). There are no previous studies that investigate if the number of drugs received in RA patients affects this adherence. REPAIR ® is a program designed with the purpose of improve data collection and medical practice in our outpatient clinic. <h3>Objectives</h3> To compare the adherence to synthetic Disease-Modifying Antirheumatic Drugs (DMARDs) among RA patients prescribed with monotherapy and combined therapy. <h3>Methods</h3> Cross sectional, observational, comparative study. This study was conducted in the outpatient rheumatology clinic of University Hospital in Monterrey, México. Consecutive patients with RA, were approached during their normal routine rheumatology appointments, in the March 2018 to December 2018 period. They were asked how many days of the last month they forgot or took their DMARDs (self-report). We classified the adherence rate in 2 categories based on the days of the last month they took the indicated medication; adequate: 75%-100% (&gt; 21 days), inadequate &lt;75% (&lt;21 days). When adherence was inadequate we interrogated about the cause. Data was obtained from REPAIR ® (internal electronic patient record). The Kolmogorov‐Smirnov test was used to determine normal distribution. Categorical variables are expressed as total number and percentage (%), and numerical variables as median and the 25th-75th percentiles (q25-q75). Chi square and Mann‐Whitney U‐test were used to compare groups and considered significant if p&lt;0.05. Data was analyzed with the statistical package SPSS version 24 (New York, USA). <h3>Results</h3> A total of 959 patients were included. When comparing adherence to treatment and gender between groups, no statistically significant difference was found. The main cause of inadequate adherence in the monotherapy group was the economic (30.3%) and own decision in the combined therapy group (29.1%). <h3>Conclusion</h3> Patients with combined therapy had the same percentage of inadequate adherence as patients with monotherapy. These results may indicate that number of drugs prescribed not necessarily affects adherence to treatment. The principal causes for an inadequate adherence to treatment were: economic for monotherapy group and own decision for combined therapy group. However, long-term studies are needed to evaluate the persistence of treatment in these groups of patients. <h3>References</h3> [1] Van den Bemt BJF, Zwikker HE, van den Ende CHM. Medication adherence in patients with rheumatoid arthritis: a critical appraisal of the existing literature. Expert Rev Clin Immunol. 2012;8(4):337–51. [2] M.F. M. Improving treatment adherence in patients with rheumatoid arthritis: What are the options? Int J Clin Rheumtol [Internet].2015;10(5):345–56. <h3>Disclosure of Interests</h3> None declared