AB1187 TREATMENT ADHERENCE: WHAT ABOUT THE RHEUMATOLOGIST?
Authors: R. Pineda-Sic, M. M. Castañeda-Martínez, I. D. J. Hernandez-Galarza, E. I. Guevara Elizondo, D. E. Flores Alvarado, G. Serna-Peña, I. J. Colunga-Pedraza, D. Á. Galarza-Delgado
Journal: Annals of the Rheumatic Diseases (2020)

Background: Adherence to medications among patients with rheumatic diseases is often suboptimal. 1 Adherence to treatment has been described to be affected by several factors. 2 The rheumatologist plays a crucial role in influencing adherence behavior by addressing perceptions about medication, providing information, and establishing trust in the treatment plan. 3 There is no record of attitudes and thoughts of Mexico’s rheumatologists about adherence to medication. Objectives: To know the rheumatologist’s attitudes regarding treatment adherence in follow up consultation. Methods: Descriptive, cross sectional study. Rheumatologists from across the country were invited to respond an electronic survey created with Google Forms, link was sent by Whatsapp ® message, responses were anonymous. The survey was constructed taking into account the main barriers of adherence related to the doctor. Seven questions were created, from one to six were multiple selections and the seven were open question 1.Where do you practice medicine? 2.Do you ask all your patients about adherence medication? 3.If your answer was positive, do you ask individually for each drug? 4.How long do you spend on explaining: side effects, benefits, and mechanisms of action of drugs? 5 Do you discuss available treatment options with your patients to decide one? 6.What’s the definition of adherence? 7.Which activities can the doctor do to improve adherence to their patients? Results: Data were collected from 158 rheumatologists who completed the survey. Regarding the question where they practice medicine, 19.5% answered they work in public medical institutions, 31.8% do private practice and 48.7% work in both of them, 88.3% answered correctly adherence definition, 93% of rheumatologists ask for adherence to medication in the follow up consultation and only 86.1% do it individually for each medication, 97.4% discuss therapeutic options with their patients. The time used to explain treatment is presented in Figure 1. The interventions considered by rheumatologists to increase adherence are reported in Table 1. Table 1 Interventions considered by rheumatologists to increase adherence Patient education (in follow up consultation, conferences, pamphlets) Develop rapport with patient. (“be accessible”, “answer questions” “make the patient part of“ don’t be paternalistic or authoritarian”) Adherence measure (Use the available method, questionnaires, self-report, drug levels, electronic pillbox, pill count, etc. “ Don’t matter which one, measure it! “) Interventions for no adherence reasons (phone calls, text messages, telephone alarms) fixed schedules for each medication, cognitive-behavioral therapy, access to medications) Family support network Presented in order to frequencies and grouped by topic Conclusion: Rheumatologists ask for adherence medication but more than half use a limited amount of time to explain about medication, nevertheless, they think that patient education is the best intervention to increase adherence. References: [1]Pasma, Annelieke et.al Facilitators and Barriers to Adherence in the Initiation Phase of Disease modifying Antirheumatic Drug (DMARD) Use in Patients with Arthritis Who Recently Started Their First DMARD Treatment, The Journal of Rheumatology (2013) DOI:10.3899/jrheum.140693. [2]M.F. M. Improving treatment adherence in patients with rheumatoid arthritis: What are the options? Int J Clin Rheumtol. 2015;10(5):345–56. [3]Voshaar et al. Barriers and facilitators to disease modifying antirheumatic drug use in patients with inflammatory rheumatic diseases: a qualitative theory-based study. BMC Musculoskeletal Disorders (2016) 17:442 DOI 10.1186/s12891-016-1289-z Disclosure of Interests: None declared