Drug-related problems reported by patients with rheumatic diseases: an observational study

Abstract

Background Drug-related problems can negatively influence treatment outcome and well-being for patients with rheumatic diseases. Thus, it is important to support patients in preventing or resolving drug-related problems as quickly as possible. To effectively develop interventions for this purpose, knowledge on the frequency and character of drug-related problems is needed. Therefore, this study aims to quantify and characterize drug-related problems reported by patients with inflammatory rheumatic diseases along their treatment process. Methods A prospective observational study was conducted in a Dutch outpatient pharmacy. Adult patients with rheumatic diseases that were prescribed medication by a rheumatologist were questioned about experienced DRPs by telephone 4 times in 8 weeks using a structured interview-guide. Patient-reported DRPs were scored on uniqueness (i.e., if a specific DRP was reported in multiple interviews by one individual, this was counted as one unique DRP) and were categorized using a classification for patient-reported DRPs and analysed descriptively. Results In total, 52 participants (median age 68 years (interquartile range (IQR) 62–74), 52% male) completed 192 interviews with 45 (87%) participants completing all 4 interviews. The majority of patients (65%) were diagnosed with rheumatoid arthritis. Patients reported a median number of 3 (IQR 2–5) unique DRPs during interview 1. In subsequent interviews, patients reported median numbers of 1 (IQR 0–2), 1 (IQR 0–2) and 0 (IQR 0–1) unique DRPs for interviews 2–4 respectively. Participants reported a median number of 5 (IQR 3–9) unique DRPs over all completed interviews. Unique patient-reported DRPs were most frequently categorized into (suspected) side effects (28%), medication management (e.g., medication administering or adherence) (26%), medication concerns (e.g., concerns regarding long-term side-effects or effectiveness) (19%) and medication effectiveness (17%). Conclusions Patients with rheumatic diseases report various unique DRPs with intervals as short as two weeks. These patients might therefore benefit from more continuous support in-between contact moments with their healthcare provider.

Drug related problems. Classification. Prevention methods

“…Это было показано в исследовании у больных ревматическими заболеваниями, которым в ходе телефонного контакта регулярно предлагали пройти структурированный опрос, касающийся возникновения тех или иных проблем, связанных с приемом ЛП. Такие интервью помогали вовремя выявить в первую очередь побочные действия назначенных ЛП, а также ряд других проблем, связанных с их приемом [37].…”

Factors Influencing Preferences of Patients With Rheumatic Diseases Regarding Telehealth Channels for Support With Medication Use: Qualitative Study

“…However, besides the positive effects of DMARDs, patients also experience multiple drug-related problems (DRPs) at various times during their treatment. On average, patients with rheumatic diseases experience 5 DRPs in an 8-week period, with patients reporting at least 1 new DRP every 2 weeks when followed up for several weeks [2]. For example, more than half of the patients experience side effects from biological DMARDs [3,4], over 90% of patients with rheumatoid arthritis experience at least 1 concern about potential adverse effects of DMARDs [5], and patients experience difficulties with adhering to their medication regimen [6,7].…”