AB0838 ADHERENCE TO TREATMENT IN PATIENTS WITH RHEUMATIC PROFILE DEPENDING ON THE OPTION OF BASIC THERAPY
Authors: O. Malyshenko, M. Koroleva, M. Letaeva, J. Averkieva, T. Raskina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Treatment adherence is an important issue in actual clinical practice. As defined by the WHO, adherence to treatment is seen as the degree to which a patient’s actions - taking medications, adhering to diet and other lifestyle interventions - correlate with following the doctor’s recommendations. Treatment of patients with rheumatic diseases continues for many years, and often for life. The identification of factors associated with adherence to therapy will justify the implementation of a number of measures in order to increase the effectiveness of treatment of patients. Biological disease modifying antirheumatic drugs (bDMARDs) therapy involves more frequent visits of patients to a doctor with close monitoring of their condition, which may have an impact on adherence to treatment in this group of patients. Objectives: to assess adherence to treatment of patients with rheumatological profile, depending on the basic therapy option. Methods: A survey of 84 patients was conducted: 48 (57.1%) women and 36 (42.9%) men, mean age 51 years (36.8; 60.3). Most patients are observed with a diagnosis of rheumatoid arthritis - 48 (57.1%) people, with psoriatic arthritis - 26 (30.9%) and with ankylosing spondyloarthritis - 10 (12.0%) people. The patients were divided into 2 groups depending on the type of basic therapy: Group 1 (40 people) - patients receiving combined therapy with bDMARDs and methotrexate; Group 2 (44 people) - patients with methotrexate monotherapy. Patients in group 1 received the following bDMARDs: 18 patients received sarilumab (200 mg sc once every 2 weeks), 22 people received secukinumab (150 mg sc once a month). All patients took methotrexate at an average dose of 17.5 (15.0; 20.0) mg / week and NSAIDs. Adherence to treatment was assessed using the Morisky-Green scale. Each of the 4 points is evaluated according to the principle of answers to the question “yes-no”, while the answer “yes” is estimated at 0 points, and the answer “no” - at 1 point. Patients who score 4 points are considered compliant (adherent); insufficiently committed and those at risk for the development of non-commitment - 3 points; not committed - 2 points or less. Results: The majority of patients are seen by a doctor monthly - 45.2% (38) and once a quarter - 33.3% (28). Only 7.1% (6) people are observed once every 6 months and 4.8% (4) once a year, and 9.6% (8) are not observed at all. The frequency of medical observations in the 1st group of patients was higher than in the 2nd: monthly - 60.0% (24) and 40.9% (18), every 3 months - 40.0% (16) and 45.5% (20), respectively (p = 0.072 and p = 0.089), and only patients of the 2nd group were observed once every 6 months (4.5% - 2 people) and once a year (9.1% - 4 people). There were no statistically significant differences in adherence indicators. When assessing adherence to treatment according to the Morisky-Green scale: only 37.5% (15) of patients in group 1 and 29.6% (13) in group 2 (p = 0.12) adhere to therapy, 30.0% are not adherent enough (12) and 22.7% (10) patients (p = 0.31), not adhering to treatment - 32.5% (13) and 47.7% (21) people, respectively (p = 0.39). Conclusion: Thus, basic therapy bDMARDs with more frequent medical supervision does not affect adherence to treatment. Only about a third of patients are adherent to bDMARDs therapy. Disclosure of Interests: None declared