POS0273-HPR PHARMACIST’S IMPACT ON SELF-MANAGEMENT FOR PATIENTS WITH CHRONIC INFLAMMATORY ARTHRITIS TREATED WITH BIOLOGICAL DMARDS
Authors: C. Bottois, C. López-Medina, S. Dumas, H. Julien, B. Sephora, C. Roux, A. Moltó, O. Conort, M. Dougados
Journal: Annals of the Rheumatic Diseases (2021)

Background: Knowledge about chronic inflammatory rheumatisc diseases and skills to administer and manage subcutaneous (subcut) biological DMARDs (bDMARDs) are key aspects to optimize patient’s self-management. Intervention of several successive health professionals (e.g comprehensive multidisciplinary team) has proven to be an effective method to improve patient’s self-management of their disease and treatment. Objectives: To assess the pharmacist’s impact on patient’s knowledge and skills during a multidisciplinary annual review. The secondary objectives were to assess this impact on therapeutic adherence and patient’s satisfaction as well as to determine the factors associated with the level of knowledge at baseline. Methods: Study type: prospective, monocentric, 6 months-follow-up, non-controlled study approved by Local Ethical Committee. Inclusion criteria: patient with either rheumatoid arthritis (RA) or spondyloarthritis (SpA), and treated with subcut bDMARDs. Intervention: The visit with a pharmacist evaluating and discussing patient’s knowledge and treatment adherence. At baseline (M0): date of the visit and, 3 (M3) and 6 months (M6) later, knowledge and adherence were assessed using self-administered questionnaires: Biosecure and CQR-5 respectively. A questionnaire was sent at M3 in order to evaluate the patient satisfaction. Endpoints: Primary: Changes in Biosecure score Secondary: Percentage of patients with high level of knowledge (score &gt; 84) and percentage of patients with high adherence at M3 and M6; patient’s satisfaction; identification of patient’s factors (socio-demographics, rheumatisc disease treatments) associated with different levels of knowledge at baseline. Statistical analysis: repeated measures ANOVA, Bonferroni and Generalized Estimating Equation, univariate and multivariate linear regression. Results: The study was conducted from October 2019 to July 2020; 79 patients were included (age (years) = 50±15; sex ratio = 1.1; RA=25, SpA=54). The Biosecure scores changed from 71±18 to 82±15 (M3) and to 84±14 (M6) (p&lt;0.001). At M0, M3 and M6, the rate of patients with a high level of knowledge was 24.1%, 59.5% and 63.3% respectively (p&lt;0.001). No difference was observed for the change in the 92% of patients considered as high adherent (92% versus 95% at M0 and M6 respectively; p=0.077). Patient’s satisfaction regarding the pharmaceutical intervention was 25±3 (max = 28). Factors associated with a better Biosecure score in the multivariate analysis were the following, lifestyle as a couple (p&lt;0.001), information given by a nurse (p=0.033), information searched for on patient associations (p=0.013) and a low Charlson score (p=0.001) Conclusion: Pharmacist’s intervention in the comprehensive multidisciplinary annual review resulted in a beneficial impact on patients’ knowledge and skills to manage their bDMARDs with a high level of satisfaction from a patient perspective. Disclosure of Interests: None declared