AB0244 MEDICATION ADHERENCE AND BELIEFS ABOUT MEDICATION IN PATIENTS WITH RHEUMATOID ARTHRITIS.

Abstract

BackgroundConsistent immunosuppressive treatment of rheumatoid arthritis (RA) with disease-modifying anti-rheumatic drugs (DMARDs) is crucial for reduced progression and improved long-term outcome of the disease. Therefore, drug adherence is a prerequisite, which is often insufficient according to literature.ObjectivesOur aim was to investigate the relationship between adherence and beliefs about medication in patients with RA.MethodsThe study included 137 RA patients (102 female, 35 male; age range 28-86 years, Ø 64.8 ± 12.6 yrs; SDAI Ø 9.9 ± 6.8; 61 % DMARD monotherapy, 31 % DMARD combination therapy, 9 % currently treated without DMARD). Medication adherence was measured with the Compliance-Questionnaire-Rheumatology (CQR). This is a self-report questionnaire with 19 items (4 response options each). The sum score is mapped to a scale from 0 to 100 % (CQR%), where 100 % corresponds to optimal adherence. A CQR% ≥ 80 % was defined as satisfactory adherence. In addition, the specific part of the Beliefs about Medicines Questionnaire (BMQ) was used to assess patients’ opinions about the necessity of their medication therapy and their concerns. Besides correlation analyses (Spearman-Rho) multiple linear regression was applied to determine factors influencing adherence (coefficient of determination: adjusted R2).ResultsAdherence was satisfactory in 93 RA patients (67.9 %) and insufficient in almost one-third (n = 44, 32.1 %). Analyses showed that adherence was significantly related to belief in necessity (r = 0.46; p < 0.001) and concerns about drug therapy (r = -0.27; p = 0.001). Furthermore, it became apparent that adherence is closely linked to the age of the patient (r = 0.30; p < 0.001). Younger RA patients (< 60 yrs) had significantly lower CQR%-scores than older RA patients (≥ 60 yrs; p < 0.01). Belief in the necessity of therapy, medication concerns and patient age accounted for almost half of the patient-specific variability in adherence (each p < 0.001; R2 = 42.9 %), suggesting a strong dependence of adherence on these three factors.ConclusionAdherence is insufficient in about one-third of RA patients. Additionally, adherence appears to be strongly dependent on the patient’s belief in the necessity of therapy, medication concerns and age. Physicians should strive for all RA patients to have sufficient knowledge about their medication, strengthen the belief in the necessity of the therapy and be mindful of adherence when talking to patients.Disclosure of InterestsNone declared