AB0919-PARE WHAT DO OLD PEOPLE THINK OF THEIR RHEUMATOID ARTHRITIS TREATMENTS?
Authors: D. Khalifa, S. Belghali, M. Limam, N. Elamri, K. Baccouche, H. Zeglaoui, E. Bouajina
Journal: Annals of the Rheumatic Diseases (2021)

Background: Managing chronic diseases such as rheumatoid arthritis (RA) is a challenge on a daily basis for rheumatologists and convincing our patients to properly take their medication may be difficult especially with elderly. First step comes with our patients’ education and suppressing misbeliefs and misconceptions. Objectives: To study beliefs of elderly RA patients on DMARDs and see what they really think of their treatments. Methods: A cross-sectional study was conducted in a rheumatology clinic over a period of 4 months. Patients over the age of 65 having RA and being treated with conventional DMARDs or biologics were questionned about their medication. The belief about medicines questionnaire (BMQ) was used to assess different beliefs. It is a validated questionnaire of 18 items. Patients responded freely to each item using a Likert scale. The clinician later collected the data and 4 scores were calculated (concern (c), necessity (n), overuse and harm), thus classifying patients on 4 different groups as follows: accepting if n≥ 15 and c&lt;15, ambivalent n≥ 15 and c≥15, indifferent if n&lt; 15 and c &lt;15 and skeptical if n&lt;15 and c≥ 15. Results: Forty elderly patients joined the study. The median of age was 66 years. They were mostly women (82.5%) with other comorbidities in 55% of the cases. The mean of DAS 28 score was 4.65± 1.77 and the mean of the VAS pain score was 5 out of 10. Only 17.5% of the patients were on remission or low disease activity. Radiological destructions were detected in 87.2% of the patients and deformities in 60% of them. Rheumatoid factor and/or citrullinated peptide antibodies were detected in 81.6% of the cases.95% of the patients were on methotrexate (MTX), 12.5% on Sulfasalazin and 12.5% on biotherapies. Corticosteroids were prescribed in 85% of the patients. Responses to the BMQ specific and general questionnaire are showed in table.1. The mean score of concern was 15.33±3.8, the mean score of harm was 13.44±2.9, the median of the necessity score was 18 and the median of the overuse score was 13.5. Analysing patients’ beliefs, the majority of them were ambivalent towards their DMARDs (44.4%), 33.4% were accepting, 11.1% were skeptical and 11.1% were indifferent. Table 1. BMQ responses BMQ specific Do not agree at all % Do not agree % Incertain % Agree % Agree very much % My health at present depends on my RA medicines 5.6 22.2% 27.8 44.4 0 Having to take RA medication worries me 5.6 44.4 0 38.9 11.1 My life would be impossible without my RA medication 5.6 16.7 22.2 33.3 22.2 Without my RA medication i would be very ill 11.1 22.2 16.7 38.9 11.1 I sometimes worry about the long-term effects of my RA medication 27.8 11.1 11.1 44.4 5.6 My Ra medication is a mystery to me 5.6 33.3 5.6 50 5.6 My health in the future will depend on my RA medication 5.6 16.7 27.8 50 0 My RA medication disrupts my life 5.6 38.9 5.6 44.4 5.6 I sometimes worry about becoming too dependent to my RA medication 0 38.9 11.1 44.4 5.6 My RA medication protects me from becoming worse 0 16.7 5.6 61.1 16.7 BMQ general Doctors use too many medicines 0 16.7 27.8 44.4 11.1 People who take medicines should stop their treatment for a while every now and then 11.1 44.4 22.2 22.2 0 Most medicines are addictive 0 5.6 22.2 61.1 11.1 Natural remedies are safer than medicines 11.1 11.1 27.8 22.2 27.8 Medicines do more harm than good 11.1 27.8 27.8 27.8 5.6 All medicines are poisons 5.6 22.2 27.8 22.2 22.2 Doctors place too much trust on medicines 5.6 16.7 33.3 27.8 16.7 If doctors had more time with patients they would prescribe fewer medicines 0 11.1 22.2 33.3 33.3 Conclusion: Elderly RA patients should me more reassured about the safety of DMARDs and the importance of taking them and try to establish a better patient-doctor relationship. References: [1]Horne R, Weinman J, Hankins M. The beliefs about medicines questionnaire: The development and evaluation of a new method for assessing the cognitive representation of medication. Psychol Health 1999; 14: 1–24. [2]Aikens JE, Nease DE, Nau DP, et al. Adherence to Maintenance-Phase Antidepressant Medication as a Function of Patient Beliefs About Medication. Ann Fam Med 2005; 3: 23–30. Disclosure of Interests: None declared