Background Lack of adherence to medication in rheumatoid arthritis (RA) can worsen disease activity.
Objectives To evaluate the risk of non-adherence to disease modifying antirheumatic drugs (DMARD) in RA patients treated with subcutaneous (SC) biological therapy.
Methods ARCO was a retrospective study in RA patients ≥18 years-old from 42 Spanish hospitals on SC biological therapy. The risk of non-adherence to oral DMARD was evaluated using the Compliance Questionnaire in Rheumatology (CQR), a questionnaire validated against an electronic medication-monitoring system, for a cut-off point of taking ≤80% of the doses. Patients completed the Beliefs About Medicines Questionnaire (BMQ) and the Carbonell satisfaction questionnaire (Spanish validated questionnaire on satisfaction with medication).
Results 364 patients were included (mean age 54.9 years [SD 12.5]; 77.5% women median RA duration 7.8 years). Complete CQR was available for 304 patients, of which 21.7% showed risk of non-adherence to oral DMARD (95% CI: 17.4 – 26.7%). The percentage was similar in men and women, and greater in extremes of age (>63 and ≤48 years-old), in those currently working and in patients with no comorbidities (Table). There was a trend to a higher percentage at risk of non-adherence in non-Caucasian patients, those with higher educational level and in those with risk of alcoholism (AUDIT questionnaire) (Table). The percentage with risk of non-adherence was similar in patients with 1, 2 or >2 oral drugs for RA, and in those treated or not with SC methotrexate, and it was higher in those who considered that the effect of their treatment for RA on the symptoms had been less than expected (38.1% vs 17.9% in those who thought it had been greater, p=0.029). No differences were seen with regard to the result of the BMQ.
Conclusions In patients with RA treated with SC biological therapy, 21.7% showed risk of non-adherence to DMARD according to the CQR (taking ≤80% of the doses). The percentage was higher in extremes of age, patients with university degree, employed, without comorbidities and in those who considered that the treatment effect on RA had been lower than expected.
Acknowledgement The ARCO study was funded by Merck Sharp & Dohme Spain.
Disclosure of Interest None declared