Session Information
Date: Monday, November 14, 2016
Session Type: ACR Poster Session B
Session Time: 9:00AM-11:00AM
Background/Purpose: Psoriatic arthritis (PsA), Rheumatoid arthritis (RA) and ankylosing spondylitis (AS) are an inflammatory arthritis causing joint damage and disability. Non-adherence to disease modifying anti-rheumatic drugs (DMARDs) remains a significant barrier to improving clinical outcomes in these diseases. We aimed to compare adherence to DMARDs and associated factors in PsA and other rheumatic diseases.
Methods: This was a cross-sectional study of people with rheumatic disease receiving DMARDs. Patients with PsA (n=108), RA (n=54) and AS (n=54) were recruited from two tertiary rheumatology centers in Turkey (Trakya and Uludag Universities). The patients who met the classification criteria were enrolled in this cross-sectional study. The Beliefs about Medicines Questionnaire (BMQ), Illness Perception Questionnaire-Revised (IPQ-R), Medication Adherence Rating Scale (MARS) were used for the assessment.
Results: Patient characteristics and treatments shown in Table 1. The Specific Necessity was significantly lower in the PsA patients than in AS (p <0.001) and RA (p <0.001) patients. General Overuse and General Harm scores were significantly higher in PsA patients than in AS (p values <0.001) and RA patients (p values, 0.04 and 0.1). These scores were also higher in RA group than in AS group (p values 0.05 and 0.02, respectively). There was no significant difference between groups in the Specific Necessity scores and MARS scores for DMARDs. In PsA patients, illness coherence and timeline cyclical scores were significantly higher than in RA patients (p values, <0.001 and 0.033, respectively). Illness coherence score was significantly lower in RA patients than in AS patients (p<0.001). Treatment control score was significantly higher in RA patients than AS (p=0.029) patients. In other IPQ subscales there were no significant differences between groups seen in Table 2 and Table 3. In PsA group, the score of BMQ- Specific Necessity negatively correlated with total score of MARS (r= -0.244, p=0.01). The other correlations between MARS and BMQ scores there were no significant differences.
Conclusion: In conclusions, PsA patients do not have strong belief in personal need for the DMARDs when compared to RA and AS. Also, PsA patients have more concerns about medicines are overused and being harmful.
| PsA (n=108) | AS (n=54) | RA (n=54) | All patients (n=216) | |
| Age (years) | 46.26±11.09 | 44.80±7.31 | 47.70±11.04 | 46.25±10.27 |
| Gender (male/female) | 23/85 | 33/21 | 3/51 | 59/157 |
| Disease duration | 7.45±7.17 | 7.94±5.01 | 8.83±7.32 | 7.92±6.73 |
| Nsaii, n% | 23 (%21.3) | 40 (%74.1) | 36 (%66.6) | 99 (%45.8) |
| Steroid, n% | 40 (%37) | 4 (%7.5) | 40 (%75.5) | 84 (%39.3) |
| Methotrexate, n% | 63 (%58.3) | 2 (%3.8) | 42 (%79.2) | 107 (%49.5) |
| Sulfasalazine, n% | 24 (%22.2) | 24 (%32.9) | 25 (%34.2) | 77 (%33.8) |
| Leflunomide, n% | 22 (%20.4) | 0 (%0) | 18 (%33.3) | 40 (%18.5) |
| Anti-TNF | 59 (%54.6) | 46 (%85.2) | 17 (%32.1) | 122 (%56.7) |
| Other treatments*, n% | 0 (%0) | 0 (%0) | 19 (%35.1) | 19 (%35.1) |
*: abatacept, rituximab, tocilizumab
| Questionnaires | PsA (n=108) | AS (n=54) | RA (n=54) | p |
| BMQ-Specific Necessity, mean (95%CI) | 13.13 (12.18-14.08) | 19.16 (18.27-20.05) | 17.39 (15.95-18.83) | <0.001 |
| BMQ-Specific Concern, mean (95%CI) | 14.49 (13.63-15.35) | 14.16 (13.42-14.91) | 14.73 (13.67-15.79) | >0.005 |
| BMQ-General Overuse, mean (95%CI) | 13.30 (12.70-13.90) | 10.86 (10.25-11.47) | 12.15 (11.33-12.96) | <0.001 |
| BMQ-General Harm, mean (95%CI) | 13.49 (12.83-14.14) | 10.27 (9.44-11.10) | 11.92 (11.08-12.75) | <0.001 |
| MARS, mean (95%CI) | 6.09 (5.79-6.39) | 5.85 (5.48-6.22) | 5.83 (5.47-6.20) | >0.005 |
| Questionnaires | PsA (n=108) | AS (n=54) | RA (n=54) | p |
| IPQ-Identity, mean (95%CI) | 5.44 (4.48-6.39) | 4.52 (3.81-5.23) | 5.15 (4.15-6.15) | >0.005 |
| IPQ-Timeline, mean (95%CI) | 18.39 (17.84-18.94) | 18.90 (18.13-19.67) | 18.05 (16.24-19.86) | >0.005 |
| IPQ-Consequences, mean (95%CI) | 18.53 (17.44-19.62) | 18.40 (17.30-19.51) | 18.05 (16.77-19.33) | >0.005 |
| IPQ-Personal control, mean (95%CI) | 17.18 (16.43-17.93) | 18.24 (17.37-19.10) | 17.19 (16.08-18.29) | >0.005 |
| IPQ-Treatment control, mean (95%CI) | 15.98 (15.38-16.57) | 16.94 (15.40-18.48) | 15.05 (14.37-15.74) | 0.029 |
| IPQ-Illness coherence, mean (95%CI) | 13.88 (13.17-14.60) | 14.07 (13.07-15.07) | 11.47 (10.92-12.01) | <0.001 |
| IPQ-Timeline cyclical, mean (95%CI) | 12.85 (12.24-13.47) | 13.75 (12.91-14.60) | 14.22 (12.98-13.85) | 0.033 |
| IPQ-Emotional representation, mean (95%CI) | 18.56 (17.55-19.56) | 18.35 (16.83-19.86) | 18.88 (17.63-20.63) | >0.005 |
To cite this abstract in AMA style:
Balci MA, Oksuz MF, Donmez S, Ozen T, Dalkilic E, Tufan AN, Pehlivan Y, Pamuk ON. Comparison of Adherence to Disease Modifying Antirheumatic Drugs in Psoriatic Arthritis and Other Rheumatic Disease [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/comparison-of-adherence-to-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-and-other-rheumatic-disease/. Accessed .ACR Meeting Abstracts - https://acrabstracts.org/abstract/comparison-of-adherence-to-disease-modifying-antirheumatic-drugs-in-psoriatic-arthritis-and-other-rheumatic-disease/