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AB1120-HPR Application of The Innovative Rheumatoid Arthritis Medication Assement Tool within A Pharmaceutical Care Model
  1. L. Grech1,2,
  2. V. Ferrito1,
  3. L. Camilleri3,
  4. A. Serracino Inglott1,
  5. L.M. Azzopardi1
  1. 1Department of Pharmacy, University of Malta
  2. 2Department of Pharmacy, Mater Dei Hospital
  3. 3Department of Statistics and Operations Research, University of Malta, Msida, Malta

Abstract

Background Pharmacists must adapt and evolve in order to face challenges and sustain the profession to continuously provide optimum personalised patient care to rheumatoid arthritis patients. Rheumatoid arthritis medication assessment tool, RhMAT is an innovative evidence-based instrument developed specifically to assess pharmacetherapy adherence to rheumatoid arthritis evidence-based guidelines and recommendations.

Objectives The objective of the study was to use the RhMAT within an outpatient rheumatology clinic to identify pharmaceutical care issues and assess therapeutic management of rheumatoid arthritis patients.

Methods Rheumatoid arthritis patients regularly attending the rheumatology clinic at Mater Dei Hospital eligible to participate in the study were offered a pharmaceutical care session. The pharmacist screened each patients' pharmacetherapy using the RhMAT at two time points, Phase 1 (time =0 months) and Phase 2 (time = approximately 12 months).The RhMAT adherence rate for each patient was calculated at both time points. A score of 50% of less was determined as low adherence, a score between 51% and 74% showed intermediate adherence and a score of 75% or more was determined as high adherence to the RhMAT.Gaps in non-adherence to the RhMAT which led to pharmaceutical care issues were documented and discussed with the clinician. Data analysis of the mean score at both phases was analysed using Wilcoxon signed rank test, SPSS verion 22.

Results A total of 78 patients (52 females) participated in the study. The mean age was 64 years (SD 12).The majority of the patients (55%) were prescribed at least one traditional disease modifying anti-rheumatic drug (tDMARD) whereas 45% were on biologic disease modifying anti-rheumatic drug (bDMARD). The most common tDMARD prescribed was methotrexate (n=52 patients). The mean RhMAT adherence rate at phase 1 was 81.7%. Following the pharmacist's contribution whereby the identified gaps leading to non-adherence such as lack of appropriate monitoring or lack of drug therapy counselling, were discussed as necessary with the respective clinician and the patient, the mean RhMAT adherence rate at the follow up session at Phase 2 statistically significantly increased to 85.2% (Wilcoxon signed rank test p value <0.05).

Conclusions The RhMAT is an innovative tool which aids pharmacists to identify adherence of prescribed pharmacotherapy in accordance to established guidelines. At the same time, the RhMAT allows pharmacists to identify gaps in individual patients care which lead to pharmaceutical care issues. Through the RhMAT, pharmacists further improve the quality of care offered to rheumatoid arthritis patients.

Disclosure of Interest None declared

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