AB1302 IMPACT OF THE COVID-19 PANDEMIC ON TREATMENT ADHERENCE AND THE ACTIVITY OF RHEUMATOID ARTHRITIS

Abstract

BackgroundDuring the COVID-19 pandemic, repetitive lockdowns and fear of SARS-CoV-2 infection compromised the treatment adherence of immunocompromised patients, particularly those with rheumatoid arthritis (RA). These therapeutic changes have certainly affected RA activity.ObjectivesTo assess the treatment adherence among RA patients during COVID-19 and the impact on disease activity.MethodsWe conducted a cross-sectional study involving patients with RA who met the ACR/EULAR 2010 criteria. To evaluate therapeutic adherence we used 2 validated scores: the Compliance Questionnaire of Rheumatology-5 (CQR-5) and the Morisky Medication Adherence Scale-4 (MMAS-4). For each patient, we compared the DAS28 score, visual analog pain scale (VAS), sedimentation rate (ESR), and C-reactive protein (CRP) before and during the pandemic.ResultsWe included 190 patients, of whom 155 were women and 35 were men. The average age was 55 ± 13.16 years. During the COVID-19 pandemic, the mean DAS28 score was 4.17 ± 1.03. Poor adherence was observed in 33% of cases according to MMAS-4 and in 34.5% of cases according to CQR-5. Patients who missed at least one consultation appointment accounted for 65% of cases. Teleconsultation was used in 17% of cases. Non-renewal of the prescription was the most frequent reason for therapeutic modification (47%). Sixty patients (31.7%) had contracted COVID-19 and the minor form was the most frequent (86% of cases). Poor therapeutic adherence assessed by the CQR-5 was significantly associated with: rural origin (p<0.001), low intellectual level (p=0.006), missed consultations (p<0.001), non-use of teleconsultation (p<0.001), and high disease activity (p<0.001). Factors associated with poor adherence according to MMAS-4 were: advanced age (p=0.01), rural origin (p=0.007), low intellectual level (p=0.004), comorbidities (p=0.003), failed consultations (p=0.001), non-use of teleconsultation (p<0.001) and SARS-CoV-2 infection (p=0.043).The correlational study showed that compared to pre-pandemic values: pain (p=0.001), ESR (p=0.008), CRP (p=0.04), and DAS-28 (p=0.001) were significantly higher during the pandemic. increased disease activity was significantly associated with the presence of comorbidities (p=0.018), low therapeutic adherence (p<0.001), and missed consultations (p=0.014). There was no significant association between SARS-CoV-2 infection and disease activity.ConclusionTreatment adherence of RA patients during the COVID-19 era was challenged. Elderly, illiterate, and rural patients were the most likely to miss their appointments and stop their treatments. These therapeutic changes were responsible for an increase in RA activity. Hence the importance of insisting on good adherence and close medical follow-up.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of InterestsNone Declared.