SAT0644-HPR COMPLIANCE OF BIOLOGIC DISEASES MODIFYING ANTI-RHEUMATIC DRUGS (BDMARDS) WITH SYSTEMIC IMMUNO-INFLAMMATORY RHEUMATIC DISEASES (SIRDS). AN ASSESSMENT OF PATIENTS’ ADHERENCE AND NON- ADHERENCE CONCERNS.
Authors: R. Thakran, S. Baghel, C. Messi, V. Kumar, S. Kapoor, S. Garg, A. Malaviya
Journal: Annals of the Rheumatic Diseases (2020)

Background: Patients with systemic immunoinflammatory rheumatic diseases (SIRDs) are often treated with bDMARDs when the response to conventional disease-modifying antirheumatic drugs (csDMARDs) is inadequate.There are, however, concerns about non-adherence to bDMARDs among patient. The non-adherence to bDMARDs may be caused by the various factors. Objectives: 1.The main objective of present study was to find out the cause of discontinuation of bDMARDs 2.To find out the adherence and non-adherence rate for bDMARDs. 3.To identify the factors that are modifiable. Methods: 800 patients with SIRDs prescribed bDMARDs were interviewed to find out the demographic information, their socioeconomic status,and the disease duration.Additional information gathered included the comorbidities, the time for starting bDMARDs, the route of administration of bDMARDs, beliefs and perceptions about treatment efficacy and side effects if any.This was followed by looking at the adherence of bDMARDs; if they had discontinued then efforts was made to find out the reasons for the same. Based on these findings the patients were classified into adherent and non-adherent categories. The data were analyzed further for 1.Factors that associated with persistence of bDMARDs. 2.Factors that were associated with discontinuation of bDMARDs. Results: A total of 800 patients were interviewed that included patients with ankylosing spondylitis 430(52.4%), rheumatoid arthritis 300(37.7%), psoriatic arthritis 45(5.2%), and others 25 (0.7%).On analysis 610(76%) patient were compliant but 190(24%) patient had discontinued the bDMARDs on their own. On comparison of both groups Factors that were significantly related to self-discontinuation were: •Negative beliefs about biologics (37%) •Cost (33%) •Reading side-effect profile on Google search (25%) •Other co-morbidities (6%) Factors that were significantly related to persistence of biologic treatment were: •Good counseling by rheumatologist and rheumatology nurse (60%) •Faith in the treating rheumatologist (25%) •Fear of deformities and pain(15%) On analysis it was found that a good counseling and clarifying the doubts of the patients regarding bDMARDs before starting the treatment encourages the patient to continue the biologic treatment, especially it allays their doubts about the drug adverse effects. Conclusion: Despite negative beliefs and misconceptions about bDMARDs, patient non-adherence at our center is not alarming.A positive reinforcement counseling appears to be the most significant factor to overcome the negative belief of patients.The affordability of the biologic treatment however remains a limiting factor in our centre as in other parts of India. References: [1]Tamas Koncz,MD,Marta,Pentek,Valentin,Brodszky,Katalin Ersek,MSc,Ewaorlewska&amp;Laszlo Gulasi Volume10,2010 –Issue9 Adherence to biologic DMARD therapies in rheumatoid arthritis Acknowledgments: no Disclosure of Interests: None declared