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Correspondence response
Education and treatment adherence during the COVID-19 pandemic. Response to: ‘Adherence to medication in patients with rheumatic diseases during COVID-19 pandemic’ by Khabbazi et al
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  1. Rita Angélica Pineda-Sic1,
  2. Griselda Serna-Peña1,
  3. Jesus Alberto Cardenas-de la Garza1,
  4. Sergio A Torres-Castillo2,
  5. Dionicio Angel Galarza-Delgado1,
  6. Diana Elsa Flores-Alvarado1
  1. 1Rheumatology, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  2. 2Servicio de Neurología, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, Mexico
  1. Correspondence to Dr Dionicio Angel Galarza-Delgado, Rheumatology, Universidad Autonoma de Nuevo Leon, Monterrey, Nuevo Leon, PC 64460, Mexico; dgalarza{at}medicinauanl.mx

http://dx.doi.org/10.1136/annrheumdis-2020-218791

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    With great interest, we read the study of Dr Khabbazi et al1 regarding treatment adherence in patients with inflammatory rheumatic diseases during the COVID-19 pandemic in the East Azarbaijan province of Iran. They conducted telephone interviews to 1324 patients and inquired about treatment adherence behaviours during 2 weeks from July 2020. Of the 858 patients included in the final analysis, non-adherence was reported by 6.5% of the patients (defined by the group as ≥20% change in the dose or frequency of medications). In accordance to previous studies,2 this work demonstrates that a small percentage of patients were non-adherent to their treatment and with a lower frequency than the one reported in our Latin American sample population (15.1%).3 The principal pattern of non-adherence was the complete discontinuation of medications (58.9%), and the most common reason (62.5%, n=35) was the fear of the immunosuppressive effects of therapy.

    Treatment adherence in rheumatic diseases encompasses a complex relationship between patients, healthcare team/system, community and economy.4 The COVID-19 pandemic has importantly impacted all of factors making treatment adherence during the current times a difficult challenge. While cross-sectional studies are limited to draw solid conclusions or design adequate strategies, they provide an important general overview of the impact of COVID-19 and adherence in rheumatic diseases in different populations. The evaluation of medication persistence and longitudinal evaluation are necessary to determine the real impact of COVID-19 on adherence behaviours. Nonetheless, strategies to diminish non-adherence should not wait for the evidence to accumulate. Education regarding the relationship between medications, rheumatic diseases and COVID-19 are key to improve adherence and dissipate patients’ fear and unfounded beliefs. Educational strategies should be promptly established worldwide to possibly limit unnecessary morbidity and mortality due to medication non-adherence.

    References

    1. ↵
      1. Khabbazi A,
      2. Kavandi H,
      3. Paribanaem R, et al
      . Adherence to medication in patients with rheumatic diseases durin COVID-19 pandemic. Ann Rheum Dis 2020. doi: doi:10.1136/annrheumdis-2020-218756.
    2. ↵
      1. Fragoulis GE,
      2. Evangelatos G,
      3. Arida A, et al
      . Treatment adherence of patients with systemic rheumatic diseases in COVID-19 pandemic. Ann Rheum Dis 2020.doi:10.1136/annrheumdis-2020-217935pmid:32475830
      OpenUrlFREE Full Text
    3. ↵
      1. Pineda-Sic RA,
      2. Galarza-Delgado DA,
      3. Serna-Peña G, et al
      . Treatment adherence behaviours in rheumatic diseases during COVID-19 pandemic: a Latin American experience. Ann Rheum Dis 2020. doi:doi:10.1136/annrheumdis-2020-218198. [Epub ahead of print: 23 Jun 2020].pmid:http://www.ncbi.nlm.nih.gov/pubmed/32576568
      OpenUrlPubMed
    4. ↵
      1. Drenkard C,
      2. Feldman CH
      . Untangling the complexity of medication adherence in SLE. Nat Rev Rheumatol 2020:6–7.doi:10.1038/s41584-020-0490-5pmid:http://www.ncbi.nlm.nih.gov/pubmed/32792662
      OpenUrlPubMed

    Footnotes

    • Handling editor Josef S Smolen

    • Twitter @ritapineda_6, @DraGrisSerna, @sactMD

    • Contributors RAP-S and GS-P, conceived the manuscript. RAP-S, GS-P, JAC-dlG, SAT-C, DAG-D and DEF-A drafted and revised the manuscript for important intellectual content.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient and public involvement Patients and/or the public were not involved in the design, conduct, reporting or dissemination plans of this research.

    • Patient consent for publication Not required.

    • Provenance and peer review Commissioned; internally peer reviewed.

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