SAT0616-HPR IMPLICATED FACTORS IN THERAPEUTIC ADHERENCE OF PATIENTS WITH RHEUMATOID ARTHRITIS: THE PATIENT´S PERSPECTIVE
Authors: M. Ahijón, P. Carreira, C. De La Cruz, R. Veiga, C. Gutierrez
Journal: Annals of the Rheumatic Diseases (2020)

Background: Therapeutic adherence has become a topic of growing interest for medical research. Studies have reported non-adherence rates of 20-50% in rheumatoid arthritis (RA) patients (1). Poor adherence has a negative impact on disease outcomes and implies an economic burden for the health system (2). Identifying the potential risk factors for non-adherence is essential to develop intervention strategies to solve this problem Objectives: To establish the contribution of illness and medication beliefs to therapeutic adherence in RA. To explore the association of treatment adherence with other patient and disease factors. Methods: RA patients ≥ 18 years old from a military hospital diagnosed with RA based on ACR /EULAR 2010 criteria were included in a cross-sectional study. Compliance Questionnaire Rheumatology (CQR) was used to assess treatment adherence. Unsatisfactory compliance was defined as taking correct dosing &lt; 80%. Illness and medication beliefs were evaluated using the “Brief Illness Perception Questionnaire “(IPQ-b) and the “Beliefs about medicine questionnaire” (BMQ). Demographic data and clinical characteristics were collected by standardized clinical interview and revision of medical records. Results: 144 patients were included the study, 106 (73.6%) women, with a mean age of 62 years (SD 12) and median disease duration of 5 years (interquartile range 25-75: 2-11). 113 (78.4%) patients showed good treatment adherence. No differences were observed regarding demographics and clinical characteristics. Strong beliefs about drugs potential damage was associated with poor compliance (13±5 vs. 11±3, p= 0.013), meanwhile increased belief in medication necessity was associated with good compliance (21±3 vs. 20±3, p= 0.015). From the illness perception measures, adherent patients had increased feeling of treatment control (8.8± 1.5 vs 7.7± 2.1,p= 0.008) and greater emotional response (6.2±3.1 vs 4.8±3.4,p= 0.042). In a multivariate analysis was found that for each unit of increase in the score of BMQ´s damage domain, adherence was reduced by 20% (CI 95% 0.7-0.9, p= 0.001); for each unit of increase in the treatment control item of the IPQ-b, adherence increased 1.42 times (CI 95% 1.1-1.8,p= 0.006); and for each unit of increase in the emotional response item of the IPQ-b, adherence increased 1.2 times (CI 95% 1.08-1.46,p= 0.002). Conclusion: Illness and medication beliefs could influence compliance to treatment in patients with RA. References: [1]van den Bemt BJ, van den Hoogen FH, Benraad B, et al. Adherence rates and association with nonadherence in patients with rheumatoid arthritis using disease modifyin antirheumatic drugs. J Rheumatol. 2009;36(10):2164–70. [2]Martikainen JA, Kautiainen H, Rantalaiho V, et al.. Longterm Work Productivity Costs Due to Absenteeism and Permanent Work Disability in Patients with Early Rheumatoid Arthritis : A Nationwide Register Study of 7831 Patients. J Rheumatol. 2016;43(12):2101–5. Disclosure of Interests: María Ahijón: None declared, Patricia Carreira Grant/research support from: Actelion, Roche, MSD, Consultant of: GlaxoSmithKline, VivaCell Biotechnology, Emerald Health Pharmaceuticals, Boehringer Ingelheim, Roche, Speakers bureau: Actelion, GlaxoSmithKline, Roche, Carmen De La Cruz: None declared, Raúl Veiga: None declared, Carlos Gutierrez: None declared