Ab1265 evaluation of Adherence to Treatment in Patients of Rheumatic Diseases

Abstract

Background:Patient adherence to treatment is one of the most important factors influencing the effectiveness of therapy, the course of the disease and the prognosis of the patient’s life. In addition to understanding the degree of adherence, it is important to study the factors that reduce patient adherence. In 2008, the Russian questionnaire for evaluation of adherence to treatment was developed, assessing adherence to drug therapy, to medical care, to lifestyle modification and general adherence to treatment. The questionnaire showed good sensitivity (93%) and specificity (78%).Objectives:Using the questionnaire, assess the level of adherence to treatment, to drug therapy, medical care and to to lifestyle modification of patients with rheumatic diseases.Methods:The study included 130 patients (30 men and 100 women) with rheumatic diseases observed in the hospital (63.1%) or outpatient (36.9%). The average age of patients was 53.1 ± 11.72 years (from 27 to 81). 69 patients (53%) suffered with rheumatoid arthritis, with ankylosing spondylarthritis 21 (16.2%), with osteoarthritis 13 (10%), with psoriatic arthritis and systemic vasculitis in 7 patients (5.4%), the remaining 10% were other rheumatic diseases. The average disease duration is 12.3 years. Patients received NSAIDs (83.8%), glucocorticoids (62.3%), methotrexate (39.2%), immunosuppressive specialty drugs (23%), cyclophosphamide (3.8%), hydroxychloroquine (3%), sulfasalazine (2, 3%), leflunomide (1.5%), azathioprine (0.8%). Based on the data obtained in points and comparing them with theoretically possible, the level of adherence was assessed as high (76% or more), medium (51-75%) and low (50% or less).Results:The high level of adherence was observed only in 12 people (9.2%), in 66 patients (50.8%) - medium and in 52 people (40%) - low. Men had a higher level of adherence (57.6%) than women (55.4%). Among those using non-traditional methods of treatment (33.1%), adherence to treatment was 54.5%, for non-applicants (66.9%) the level of adherence was higher - 56%.The average level of adherence to drug therapy was 61%, to medical care - 65%, to lifestyle modification - only 48.8%. The degree of adherence to lifestyle changes was slightly higher among women - 48.3% than among men - 47.6%. Patients suffering from rheumatic diseases from 5 to 10 years - 53.4% had a higher level of adherence to lifestyle changes than patients suffering from less than 5 years (48.2%) and more than 10 years (45.2%). Patients with osteoarthritis have a higher level of adherence to treatment (58%) than patients with rheumatoid arthritis (55.8%), ankylosing spondyloarthritis (56%), and psoriatic arthritis (56.1%).Conclusion:In patients with rheumatic diseases, 40% showed a low level of adherence to treatment, 50.8% - an average level, which indicates a lack of adherence. The lowest level of adherence is noted for modifying the lifestyle - 48.8%, which depended on the sex and duration of the disease.ReferencesAll these factors must be considered when discussing the strategy and tactics ...