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THU0151 Assessment of compliance of rheumatoid arthritis patients in cognitive dysfunction
  1. E. Grunina1,
  2. A. Tkachev2
  1. 1N. Novgorod State Medical Academy, N. Novgorod
  2. 2Milton H. Erickson Institute of West Siberia, Novosibirsk, Russian Federation


Background Compliance decline may result in a decrease of treatment effectiveness in rheumatoid arthritis. RA patients had global cognitive impairment, which was associated with disease activity and immune changes.1 Cognitive dysfunction may have a negative effect on the results of traditional methods of compliance assessment.

Objectives Our aim was to develop the method of structured and algorithms interview to assess compliance and cognitive functions in patients with rheumatoid arthritis.

Methods 240 patients fulfilling EULAR 2010 classification criteria for rheumatoid arthritis were examined. Pain in the joints was assessed using a visual analogue scale, the clock-drawing test was used, the structured and algorithms interview with clear determination of at least 3 levels of patient values was performed.2 Each patient chose the subject of the interview: compliance, pain or side effects of drugs. Subjective values that determine the choice and behaviour of the patient with dichotomy, for example, taking or missing drugs were revealed.

Results 162 patients chose the theme of the interview concerning of pain, 50 patients chose the theme compliance with drug therapy, 38 patients - side effects of drugs. The criteria of cognitive dysfunction were the following: inability for the patient to determine subjective values influencing the process of decision- making, repeating one value with inability to built a value hierarchy, a limited number of the levels of the value hierarchy. The indirect criterion was the duration of the structured interview as the measure of patient’s and interviewer’ s efforts. Cognitive dysfunction determined by the method of the structured interview was connected with the low score of the clock-drawing test. Compliance decline was noticed in the presence as well as in the absence of cognitive dysfunction. Determining values and their hierarchy may lead to the increase of patients’ compliance.

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Conclusions The method of the structured and algorithms interview with the assessment of the hierarchy of values is used to assess compliance and cognitive functions in patients with rheumatoid arthritis as well as to reveal the ways to increase compliance.

References [1] Clin Rheumatol2018Jan 25. doi:10.1007/s10067-018-3990-9

[2] Luksha P, Tkachev A. Journal: Kybernetes, ISSN: 0368–492X, Year: 2007;36(7–8):956–971. doi:10.1108/03684920710777487

Disclosure of Interest None declared

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