Background Non-adherence to therapy is one of the main obstacles achieving the goals of care in chronic autoimmune inflammatory diseases, including Rheumatic diseases (RMDs). In the “ MOSAICO” study, ANMAR along with two other associations of Italian patients (AMICI chronic inflammatory bowel diseases (IBD) and ANAP - psoriasis (PSO) and chronic dermatological diseases) wanted to compare the adherence to therapies for IBD, RMDs and PSO and identify key problems that can affect it positively or negatively. This paper presents the results related to adherence to treatment, the obstacles that are disadvantageous and to the factors that, conversely, favor adherence and persistence.
Objectives to fix the degree of adherence to therapy - with DMARDs and biological indifferently - in the three different pathologies; to identify obstacles and factors predisposing good adherence and persistence by patients; to compare the three different populations, highlighting similarities and significant differences
Methods a 72 questions questionnaire - about 50% of which were dedicated to adherence and persistence to therapy and the predisposing factors and impediments - prepared in collaboration with Doxapharma was administered to patients with RMDS, IBD, PSO via web and by volunteers of the three associations. The evaluation of adherence to therapy (“degree in which a person's behavior in taking medication, following a diet and/or change the lifestyle, corresponds to the specific recommendations made in agreement with the Medical”) was assessed by Morisky Medication Adherence Scale - 8 items (MMAS-8)
Results 1.017 patients - 233 with RMDs (AR e SA), 449 with IBD (Crohn and ulcerative colitis), 273 with PSO and 62 APs –answered to the questionnaire useful for the purpose of the study.
Non-adherence varies in a range from 50% of dermatological patients, to 44% of them with IBDs, to 40% of patients with APs, to 36% of them with RMDs. Only 74.8% of adherent people is persistent (83% in biologic therapy; 76% in DMARDS) and non-persistent patients does not ask and/or inform their doctors.
Patients with Psoriasis take therapies more discontinuously and inaccurately then all the others.
good support from doctors and health professionals
satisfaciton with information received
the best QOL
easiness and lack of problems in taking drugs
satisfaction with the therapy
biologic therapies (even for the best QoL ensured)
Promote discontinuity and non-adherence:
dissatisfaction with the relationship with doctors and health professionals (33% ÷ 70% of patients is dissatisfied)
Conclusions Our study shows that patients who enjoy a better health state, both physically and psychologically, are more likely to follow the treatment prescribed by their doctor, according to the mode and the specified time, especially if properly informed and well supported in choices, shared by medical and health professional staff.
Disclosure of Interest None declared
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