AB0247 INSIGHTS INTO ADHERENCE AND PATIENT-INITIATED MONOTHERAPY FOR RHEUMATOID ARTHRITIS VIA A GLOBAL SURVEY OF PATIENTS, CAREGIVERS AND PHYSICIANS

Abstract

Background Treatment satisfaction and adherence remain issues affecting outcomes for patients (pts) with rheumatoid arthritis (RA). A better understanding of the reasons for non-adherence, and differences between pt, caregiver and healthcare professional (HCP) views on adherence, may improve decision-making and outcomes. Objectives To survey pts, caregivers and HCPs, in order to investigate pt behaviours and attitudes, and communications between pts, caregivers and HCPs regarding adherence to RA therapy. Methods Surveys were conducted online by Harris Poll between Oct and Nov 2018, among pts/caregivers and HCPs from Australia, Brazil, Canada, Germany, Japan, Spain, Taiwan, UK and US. The pt survey included pts aged ≥18 years with a diagnosis of RA who had taken conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) with biological (b)DMARDs in the past 3 years. The caregiver survey included adults aged ≥18 years who lived with/provided care to a spouse/family member with RA and were involved in ≥2 care activities for a pt with RA who had taken csDMARDs with bDMARDs in the past 3 years. The HCP survey included responses from licensed rheumatologists (orthopaedists in Japan) who saw ≥10 pts with moderate/severe RA per month, ≥10% of whom had been prescribed a bDMARD. A post-weight was applied to raw data to adjust for the relative adult population size of each country vs the total for all 9 countries surveyed. Results In total, 900 pts, 714 caregivers and 840 HCPs responded to the surveys. Overall, 50% of both pts and caregivers reported that pts always took their current RA prescription medications exactly as directed. However, 67% of pts reported that they had not always adhered to dosing regimens (most common deviations: skipping doses [45%]; extending time between doses [44%]; taking other medications without HCP direction [38%]; taking less than the prescribed dose [34%]; dose splitting [31%]; and stopping medications altogether [28%]). Among HCP respondents, 98% reported asking pts about adherence to RA medication, even though 61% felt there was no way of knowing if pts were taking medications as prescribed and, overall, HCPs responded that 64% of pts did not always take RA medication as prescribed. While 87% of HCPs agreed that bDMARDs were most effective when taken in combination with csDMARDs and 92% reiterated this to pts, 62% were concerned that pts take bDMARDs without csDMARDs. Pts and caregivers reported that pts often stopped taking csDMARDs; however, HCPs underestimated the number of non-adherent pts (Figure A). The most common reason given by pts and caregivers for non–adherence to RA medication was difficulty in remembering to take medication; however, concerns about feeling ill and potential side effects were also common (Figure B). Despite this, 47% of pts and 51% of caregivers responded that pts often don’t share all side effects caused by their RA medication with HCPs, while 38% of HCPs believed that pts did not inform them of all side effects. Conclusion This study from a large, multinational cohort of pts with RA, caregivers and HCPs describes medication adherence patterns. Pts on bDMARDs often did not take their background csDMARDs; however, the extent of pt non-adherence was underestimated by HCPs. These results highlight gaps in communication and understanding of non-adherence between pts, caregivers and HCPs. Acknowledgement Study sponsored by Pfizer Inc. Medical writing support was provided by Anthony G McCluskey, PhD, of CMC Connect and funded by Pfizer Inc. Disclosure of Interests James Galloway Consultant for: Pfizer Inc, Ara Dikranian Consultant for: AbbVie, Pfizer Inc, Speakers bureau: AbbVie, Pfizer Inc, Cheryl L Koehn Shareholder of: Arthritis Consumer Experts, Grant/research support from: Canadian Institutes of Health Research, Arthritis Research Canada, St. Paul’s Hospital, Employee of: Arthritis Consumer Experts, David C Gruben Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, John Woolcott Shareholder of: Pfizer Inc, Employee of: Pfizer Inc, Sander Strengholt Shareholder of: Pfizer Inc, Employee of: Pfizer Inc