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SP0164 Barriers and facilitators to adherence to medication in patients with inflammatory arthritis
  1. K Koutsogianni
  1. The Arthritis Foundation of Crete, Heraklion, Crete, Greece

Abstract

Background Inflammatory arthritis can cause pain, stiffness, joint damage and even disability without proper and early guided treatment. The full benefits of several treatments recommended, can be achieved if patients strictly follow drug regimens. However, rates of adherence to prescribed medications in patients with inflammatory arthritis seem to be suboptimal.

Objectives To identify the barriers and facilitators for adherence to medication on patient's perspective and to suggest ways to facilitate the patients with chronic conditions as the inflammatory arthritis are, to understand the value of compliance to treatment.

Methods The problem of poor patient compliance was detected about 2,000 years ago when Hippocrates taught his students to pay particular attention to the analysis of the causes that led their patients to lie regarding compliance with medical instructions given to them. The adherence to medication of patients suffering from chronic diseases reaches only 50% (WHO-2003) while the rate of compliance to prescribed medicines for patients with rheumatoid arthritis tend to be quite low and range from 30–80%.

Fear and insecurity about the side effects of the medicines, the doubt of efficacy of medications, the refusal to accept the IA diagnosis and the long term treatments, the desire to stop treatment to be free of the ongoing dependency on medication, the lack of competence by some physicians to involve the patient in the treatment procedure and the large amount of patients co-payment are the most significant barriers to patients adherence. A survey conducted among patients of the Arthritis Foundation of Crete aiming to assess the degree of their adherence to MTX showed that 1 in 4 patients reported missing at least one dose of MTX on their own initiative during the last 6 months without referring to their doctor and the main reason was due to side-effects.

Experiencing beneficial effects of the medications and being able to maintain autonomy and social participation, receiving clear and understandable information about the treatment options, having support from family and friends, having a good relationship with the treating physician and being involved in shared decision making process are the keys for leading the patients to better adherence.

Conclusion A good patient-health professional relationship, knowledge about treatment options and appropriate amount of information provided by HCPs as well as the patients' acceptance of their health condition and understanding of the necessity of long term therapy appear to improve adherence to medication for patients with inflammatory arthritis.

Disclosure of Interest None declared

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