Assessment of Rheumatoid Arthritis Patients’ Adherence to Treatment

Abstract

Background: Reports on adherence among patients with rheumatoid arthritis (RA) in Egypt and the Middle East region are lacking. This study aimed to measure adherence to treatment among a sample of patients with RA at Ain Shams University Rheumatology outpatient clinic and to assess factors affecting it. Methods: A crosssectional descriptive study was carried out at the rheumatology outpatient clinic on a sample of 140 patients with RA. An interview questionnaire was used to measure adherence using the 8-item Morisky's scale, factors affecting adherence to treatment like patients satisfaction were assessed using the short form patient satisfaction questionnaire, also patients' knowledge, beliefs and rate of prescription refilling were assessed. Disease Activity Score-28 was used as an objective method to assess RA disease activity. Results: According to Morisky's scale, 90.6% and 9.4% were classified as low and moderately adherent, respectively, none was classified as highly adherent to treatment. Important barriers to adherence reported were fear of side effects, nonavailability of free drugs in hospital pharmacy and cost of medications. Younger patients (P 5 0.002) and those reporting greater general satisfaction (P 5 0.02) were more likely to be adherent. In addition, on-time refill rates of medication (P 5 0.001) and disease activity (P 5 0.02) were associated with higher adherence scores and thus further validated the results of the adherence questionnaire. Conclusions: Higher adherence was associated with more positive beliefs on medication, greater satisfaction with health care and less disease activity.

AB0192 Serum measures of type i collagen degradation are surrogate markers of joint destruction and progression; first steps towards a prognostic score

“…Importantly, the markers with strongest influence were those associated with MMP-driven bone (ICTP) and connective tissue (C1M) remodelling. References: [1] Smolen JS.Tocilizumab inhibits progression of joint damage in rheumatoid arthritis irrespective of its anti-inflammatory effects: disassociation of the link between inflammation and destruction. Ann Rheum Dis 2012.…”

“…Objectives: Serological markers together with clinical parameters was tested in a multi-marker model to assess its ability to objectively predict progression of RA. Methods: Current post-hoc analysis included RA patients from the biomarker substudy of the phase III clinical study LITHE investigating the safety and efficacy of tocilizumab [1][2][3][4] . Patients had moderate/severe, active RA.…”

Fears and beliefs of people living with rheumatoid arthritis: a systematic literature review

“…Other eight articles in the same category (61.5%) analyzed the consequences of patients' beliefs about drugs on adherence. Although most patients with RA believed their synthetic and biological DMARDS were necessary to preserve joint structures, reduce pain and increase quality of life, levels of concern about side effects were high and related to non-adherence [3,5,15,16,[41][42][43][44]. Beliefs about cause of disease expressed by RA patients in 9 studies (12.1% of articles reporting beliefs) included: hereditarity, stress, unexpressed grief, diet, occupational factors/overwork, lack of exercise, God's will, weather conditions, biological reasons/immune system failure/autoimmunity, accident/chance and karmic explanation (disease caused by past "bad" actions) [18,36,43,[45][46][47][48][49][50].…”

AB0191 Clinical significance of multiple autoantibody specificities in rheumatoid arthritis: the role of anti-citrullinated alpha enolase and anti-interferon inducible protein 16

“…The identification of the diagnostic and/or prognostic value of such novel auto-Abs is under intense investigation. We recently demonstrated that RA patients display a higher prevalence of auto-Abs against the interferon-inducible protein 16 (anti-IFI16) but these auto-Abs do not have a good diagnostic value (1). Recent data showed that auto-Abs against citrullinated alpha-enolase (anti-CEP1) are associated with erosive RA (2).…”

“…Auto-Abs were assessed as follows: anti-CCP EDIA 2nd generation ELISA kit (Eurodiagnostica); anti-CEP-1 IgG ELISA kit (Euroimmun). In a subgroup of 113 patients also anti-IFI16 auto-Abs were assessed with an in-house ELISA kit (1). Clinical and serological records of patients were collected and statistical analysis was performed with SPSS 21.0 software.…”