SAT0645-HPR MYTHS AND MISCONCEPTION ABOUT THE ILLNESS AND CONVENTIONAL SYNTHETIC DMARDS (CSDMARDS) IN PATIENTS WITH SYSTEMIC IMMUNO-INFLAMMATORY RHEUMATIC DISEASES (SIRDS): A STUDY BY RHEUMATOLOGY NURSE COUNSELOR
Authors: R. Thakran, S. Baghel, L. Khurshid, S. Kapoor, S. Garg, A. Malaviya
Journal: Annals of the Rheumatic Diseases (2020)

Background: Myths and misconceptions about illness and conventional disease modifying anti-rheumatic drugs directly influence adherence to the prescribed treatment. It is estimated that 30–50% of patients do not adhere to their prescribed treatment due to various reasons where the beliefs of the patients play a crucial role. At our centre we the specialist rheumatology nurse counsel the patients at every visit and try to remove their myths and negative beliefs about the disease as well as the medications. Objectives: •To explore the common myths and misconceptions of regarding their disease and regarding the csDMARDs. •To assess the efficacy of counseling in allaying their unfounded fear. Methods: A total of 450 patients with SIRDs at least 3 times attended the rheumatology out-patient clinic on csDMARDs were enrolled to complete a questionnaire that, besides demographic information, socio-economic status, and co- morbidities, had the following questions: 1.Self reported adherence to medication 2.Misbelieves regarding food items 3.What kind of health-provider was consulted at the onset of the symptoms 4.Their belief/knowledge regarding: A. The need for physiotherapy. B. Life style modification requirement C. About osteoarthritis D. Medication requirement during remission E. Pregnancy and DMARDs F. The need of vaccination G. Health hazards of smoking and alcohol use H. Harms of discontinuing treatment when they felt well Results: A total of 450 patients included spondyloarthropathy 150(34%), rheumatoid arthritis 200(45.7%), psoriatic arthritis 45(10%), and others 25(5.5%).The following observations was made: 1.Self-reported adherence to medication was in 250 (55%) patients; 200(45%) patient were non-adherent to treatment 2.382/450 (85%) patients had misbelieves regarding different food items. 3.225/450(50)% of the patients were not doing regular physiotherapy they were totally dependent on medications for symptoms relief. 4.387/450 (86%) patients confused the symptoms of osteoarthritis with that of RA. 5.315/450 (70 %) patients did not feel the requirement of continuing drugs during remission. 6.135/450 (30%) patients believed that while on DMARDs they cannot contemplate pregnancy. 7.351/450(78%) patients accept the need for vaccination when staring DMARDs 8.360/450 (80%) patients aware about side effect of smoking in disease but only 40 % were able to quit. 9.273/450 (60%) patients felt that more expensive medicines e.g.bDMARDs have more effects. 10. 360/450 (80%) patients believed that DMARDs were ‘steroids’ and they increased weight. On analysis one patient have more than two myths simultaneously. Conclusion: Increased awareness of the patient’s beliefs about medicines is needed among health care providers. We should encourage patients to express their views about medicines as well as disease in order to optimize and personalize the information process. This can stimulate concordance and adherence to medication and follow up.These myths are deeply rooted in our society, single sitting counseling is not enough, and reinforcement is needed. References: [1]Tom Greenhalgh. Facts about rheumatoid arthritis: 7 myths you may encounter. Rheumatology Advisor. March 28, 2019. Acknowledgments: no Disclosure of Interests: None declared