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AB1236 Therapeutic adherence and satisfaction in a rheumatology consultation
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  1. C. Iñiguez Ubiaga,
  2. C. Moriano,
  3. M. Garijo Bufort,
  4. A. Crespo Golmar,
  5. I. GonzalezFernandez,
  6. C. Alvarez Castro,
  7. A. Lopez Robles,
  8. M. Martin Martinez,
  9. E. Diez Alvarez,
  10. T. Perez Sandoval
  1. Unidad de Reumatología, Complejo Hospitalario de León, León, Spain

Abstract

Background The lack of treatment adherence to is considered the main reason for therapeutic failure. It entails a high health care cost, both direct and indirect, affecting the patient‘s morbidity and mortality. In order to measure this adherence, there are different methods, which can be both objective and subjective. The ideal is the combination of both types in order to ensure that the data are as close as possible to reality.

Methods We carried out an anonymous voluntary survey in October 2017 concerning the degree of satisfaction and therapeutic adherence of patients under follow-up in outpatient Rheumatology Consultations, selecting demographic data from them and using a MARS questionnaire for chronic diseases, which is validated in Spanish. This questionnaire consists of 30 questions that include items about beliefs, experiences and behaviour in terms of health. A score higher than 25 indicates good compliance, while a score lower means a suboptimal compliance.

Results 201 surveys were collected, excluding those patients whose consultation was the first one and those who rejected their participation. The data analysis was performed descriptively with Microsoft Excel. 61% of the surveys collected were carried out by women, with an age range between 55 and 70 years (35%). 45% of the patients surveyed had a basic level of education and 28% had an average level of education, representing both of them three quarters of our sample. When we analyse the treatments that our patients receive, the most prevalent are the DMARDs, which represent 35% of the treatments, followed by the corticotherapy and biological drugs (25% and 16% respectively). Approximately 50% of the survey respondents stated that they had no problems with their medication, and in a small percentage (14%), they claimed they had problems, mostly digestive in relation to the administration of subcutaneous Methotrexate. A 14.92% of questionnaires that were not correctly completed were discarded. Out of the 171 surveys, only one respondent was considered to have a good compliance, being the compliance of the remaining respondents suboptimal. This can be influenced by the limitations of understanding due to the language used, taking into account the characteristics of our population, mainly aged and with a primary level of education, as well as the place where the survey was completed. We obtained 74% of satisfaction with the information shared in the consultation, 73% considered that enough time was devoted to said consultation and 98% said they followed the treatment regimens. However, 11% and 21% said they changed the regimen according to their lifestyle and according to how the treatment made them feel and only 55% had clear treatment options available.

Conclusions The lack of therapeutic adherence is one of the fundamental factors of therapeutic failure. There is no a single method for its assessment. Our patients show a suboptimal therapeutic compliance, although we have to take into account the limitations of the survey carried out. We must bear in mind the sociological aspects that can hinder adherence and re-assess it periodically for possible changes, as well as individualise each patient.

Disclosure of Interest None declared

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