AB1561-HPR EVALUATION OF SELF-MANAGEMENT AND SAFETY OF PATIENTS TREATED WITH TARGETED TREATMENT BY THE BIOSECURE QUESTIONNAIRE AND PREDICTION OF THE RISK OF INFECTION EVENT BY ANALYSIS OF THIS QUESTIONNAIRE
Authors: M. Beissat, M. Geoffroy, L. Bolko, A. Hittinger, I. Charlot, J. H. Salmon
Journal: Annals of the Rheumatic Diseases (2024)

<h3>Background:</h3> Patient therapeutic education (TPE) plays a central role in the chronic inflammatory rheumatic diseases management. The BIOSECURE questionnaire was developed and validated in 2012 to evaluate self-management and safety of patients treated by targeted treatment. <h3>Objectives:</h3> Our, aim was to evaluate patients' skills using the BIOSECURE questionnaire. The secondary objectives were to determine associated factors with a low level of knowledge according to the BIOSECURE questionnaire and to define the optimal threshold to predict risk of infectious event occurrence. <h3>Methods:</h3> We did a single-center, descriptive and observational study at the Reims University Hospital between January and July 2023. We included patients treated with targeted treatment for chronic inflammatory rheumatism. Biosecure score, demographic and medical data as well as access to ETP (including a TPE group or individual session and/or brochures about their disease and/or treatment) were collected for all patients. The population was divided into quartiles. Patients with the lowest score were compared to patients with the highest score. A secondary analysis has been performed to assess the risk infectious event (severe infections and/or repeated infections with more than 3 antibiotic treatments per year) according to the BIOSECURE questionnaire. ROC curves were used to evaluate the prognostic value of the BIOSECURE score in predicting occurrence of infectious event. <h3>Results:</h3> One hundred and seventy twelve patients were included, 51.2% of them had rheumatoid arthritis. and 92.2% received TPE. The median [IQR] BIOSECURE score was 74.75/100 [IQR 63.70-83.91]. Patients who had received TPE had a higher BIOSECURE score (p&lt;0.05). On multivariate analysis, associated factors with low BIOSECURE score were: male gender, retirement and a low level of education (p&lt;0.05). There was no difference in the BIOSECURE questionnaire score related to diagnosis, patient living place, hospital versus private practice or administration route. Event infection occurrences a trend be more frequent in patient with low BIOSECURE score n=13 (36.1%) versus n=7 (16.7%) (p=0.09); and more comorbidities (p=0.07). BIOSECURE score ≤ 48.6/100 predict the risk of infectious event (specificity 91.9%, sensitivity 16%, AUC: 0.6 (p&lt;0.05)). Our data are similar with litterature (Orefice D, 2014 and Rat AC, 2017). As in our study, a low level of education and being unemployed favored a low rate of correct answers. The same trend was true regarding the lack of a TPE session or a brochure (Rat AC, 2017). The median score of BIOSECURE in these studies was 73/100. <h3>Conclusion:</h3> In our study, which included all chronic inflammatory rheumatic diseases, we found a median BIOSECURE score of 74.75/100. BIOSECURE questionnaire analysis in our population provides two practical messages: -Associated factors with a low BIOSECURE score are: men, patients with a low level of education and retired people. This population may be a priority target for TPE. -BIOSECURE score ≤ 48.57/100 is the optimal threshold for predicting the occurrence risk of infection event (severe infections and/or repeated infections with more than 3 antibiotic treatments per year). <h3>REFERENCES:</h3> <b>NIL.</b> <h3>Acknowledgements:</h3> <b>NIL.</b> <h3>Disclosure of Interests:</h3> <b>None declared.</b>