ADHERENCE TO DISEASE-MODIFYING ANTIRHEUMATIC DRUGS IN RHEUMATIC DISEASES

Background: There has been seen a low adherence to treatment in patients with rheumatic diseases, which can have important consequences in disease prognosis. Although literature in Latin-American population is scarce, a previous study evaluating medication adherence in this population reported a 16.4% prevalence of adherence in Rheumatoid Arthritis (RA) and 45.9% in Systemic Lupus Erythematosus (SLE) patients (1). It has been demonstrated better outcomes in patients with rheumatic conditions who have good adherence to treatment therapies (2). Objectives: To describe the adherence to synthetic Disease-Modifying Antirheumatic Drugs (DMARDs) in patients with rheumatic diseases from a Mexican outpatient rheumatology clinic. Methods: This study was conducted in the outpatient rheumatology clinic of University Hospital in Monterrey, México, cross-sectional, descriptive, self-report adherence study. Consecutive patients with RA, SLE, Inflammatory Myopathies, Psoriatic arthritis (PsA), Systemic Sclerosis (SSc) were approached during their normal routine rheumatology appointments, in the March 2018 to December 2018 period. They were asked how many days of the last month they forgot or took their DMARDs. We classified the adherence rate in 4 categories based on the days of the last month it took the indicated medication; good: 75%-100% (> 21 days), regular 50-74% (21-15 days), bad 25-49% (14-8 days) and null: <25% (< 7 days). When adherence was not good we interrogated about the cause. Data was obtained from REPAIR ® (internal electronic patient record) and analyzed with the statistical package SPSS version 24. Table 1 Adherence for Rheumatic Disease Group n (DMARDs) Good n (%) Regular n (%) Bad n (%) Null n (%) Rheumatoid Arthritis 1,686 1442(85.5) 105(6.2) 47(2.8) 92(5.5) Systemic Lupus Erythematosus 440 393(89.3) 16(3.6) 12(2.7) 19(4.3) Inflammatory Myopathies 91 83(92.1) 2(2.2) 0(0) 6(6.6) Psoriatic arthritis 84 76(90.5) 1(1.2) 3(3.6) 4(4.8) Systemic Sclerosis 91 80(87.9) 6(6.6) 1(1.1) 4(4.4) N 2,392 Table 2 Reasons for Bad or Null adherence Rheumatoid Arthritis % Systemic Lupus Erythematosus % Inflammatory Myopathies % Psoriatic arthritis % Systemic Sclerosis % Economic 30.1 33.3 37.5 37 20 Own decision 27.9 33.3 12.5 25 40 Side effects 11.5 11.1 12.5 12.5 0 Lack of availability 15 13.3 12.5 12.5 40 forgetfulness of dose 11.9 4.4 25 12.5 0 Other 3.5 4.4 0 0 0 Conclusion: Adherence in this group of patients was good, for the definition used in our study. The method used (self-report) is very sensitive to detect non-adherence, but it overestimate good adherence, therefore the potential bias of results must be considered and confirmed whit objective measurement. The main reason for poor or no adherence was the economic, with the exception of the Ssc group it was their own decision and the patients with SLE that had the same percentage for economic and self-decision. REFERENCES: [1] - Resende Prudente L, Souza Diniz J, Matteucci Ferreira TXA, Marçal Lima D, Antônio Silva N, Saraiva G, et al. Medication adherence in patients in treatment for rheumatoid arthritis and systemic lupus erythematosus in a university hospital in Brazil. Patient Preference and Adherence. 2016:10 863–870 [2] - Waimann ChA, Marengo MF, de Achaval S, Cox VL, Garcia-Gonzalez A, Reveille JD. Electronic Monitoring of Oral Therapies in Ethnically Diverse and Economically Disadvantaged Patients With Rheumatoid Arthritis. Arthritis & Rheumatism. 2013:6 1421-1429. Disclosure of Interests: None declared DOI: 10.1136/annrheumdis-2019-eular.7905Citation: Ann Rheum Dis, volume 78, supplement 2, year 2019, page A1681Session: Rheumatoid arthritis - non biologic treatment (Scientific Abstracts)