Session Information
Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
Background/Purpose: Disabilities in daily living and quality of life are key endpoints to evaluate the outcome of treatment for rheumatoid arthritis (RA). Among factors that may contribute to good outcome are adherence and health literacy.
Methods: The survey included a representative, nationwide sample of German physicians specialized in RA and patients with RA. The physician questionnaire included the disease activity score (DAS28) and medical prescriptions. The patient questionnaire included fatigue (EORTC QLQ-FA13), health assessment questionnaire (HAQ), quality of life (SF-12), health education literacy (HELP), and patients’ listings of their medications.
Adherence was operationalized in various ways: patient-reported (CQR5), behavioral (correspondence between physicians and patients listings of medications), physician-assessed (five-point rating scale ranging from 1=very adherent to 5=not at all adherent) and a combined measure of physician rating (1= very adherent, 0 = less adherent) and the match between physicians’ prescriptions and patients’ accounts of their medications (1 = perfect match, 0 = no perfect match), leading to three categories of adherence: high, medium and low. Linear regressions were calculated using HAQ and SF-12 (physical and psychological) as dependent variables and adherence, health literacy and the set of demographic and clinical variables as predictor variables.
Results: A total of 708 pairs of patient and physician questionnaires were analyzed. The mean age of the patients, of whom 73% were women, was 60 years (SD=12). All results are shown in the multiple regression analyses.
Conclusion: This study showed that HAQ and SF-12 were related to adherence and health literacy. This finding highlights the importance of patient education and counseling in order to increase both, medical understanding and adherence to therapy.
Table 1: Patient characteristics
|
Sociodemographics |
Prescribed medications |
||
|
Age |
60 (SD 12) |
Total number of prescribed medications |
4.9 (SD .27) |
|
Sex, male |
193 (27%) |
MTX |
411 (58%) |
|
Relationship status, married |
512 (72%) |
DMARD, without MTX and Biologica |
169 (24%) |
|
Children, yes |
449 (63%) |
Biologica |
301 (43%) |
|
Education, matriculation standard |
203 (29%) |
Glucocorticoide |
416 (59%) |
|
Occupation, employed |
286 (40%) |
|
|
|
Insurance, compulsory health insurance |
644 (91%) |
|
|
Table 2: Multiple linear regression models
|
HAQ* |
SF-12 Physical |
SF-12 Psychological |
||||||||
|
MLR model* |
Predictor |
B (95%-CI) |
p-value |
R² |
B (95%-CI) |
p-value |
R² |
B (95%-CI) |
p-value |
R² |
|
Model 1 |
All 4 rheumatism agents taken as prescribed |
4.41 (.45, 8.38) |
.029 |
20% |
2.39 (.51, 4.28) |
.013 |
16% |
.34 (-1.67, 2.35) |
.741 |
15% |
|
Adherence by doctor (ref. medium or less adherence) |
|
|
|
|
|
|
||||
|
adherent |
1.79 (-3.89, 7.45) |
.534 |
3.14 (.43, 5.86) |
.023 |
.74 (-2.15, 3.64) |
.615 |
||||
|
Very adherent |
3.01 (-2.56, 8.58) |
.289 |
3.28 (.61, 5.95) |
.016 |
3.10 (.254, 5.95) |
.033 |
||||
|
Health education literacy* |
.330 (.229, .431) |
<.001 |
.141 (.093, .189) |
<.001 |
.220 (.169, .272) |
<.001 |
||||
|
Model 2 |
All 4 rheumatism agents taken as prescribed |
3.22 (-.87, 7.32) |
.123 |
20% |
2.00 (.04, 3.96) |
.046 |
15% |
-.11 (-2.20, 1.98) |
.919 |
15% |
|
Adherence composite score (ref. low adherence) |
|
|
|
|
|
|
||||
|
medium adherence |
2.22 (-1.16, 6.06) |
.256 |
.67 (-1.17, 2.51) |
.476 |
.12 (-1.84, 2.08) |
.905 |
||||
|
high adherence |
5.06 (.62, 9.50) |
.026 |
1.48 (-.65, 3.61) |
.172 |
2.74 (.47, 5.01) |
.018 |
||||
|
Health education literacy* |
.323 (.222, .423) |
<.001 |
.141 (.093, .190) |
<.001 |
.223 (.171, .274) |
<.001 |
||||
All models are adjusted for sex, age, drinking alcohol (y/n), smoking status (y/n) and sport activities (y/n);
B, regression coefficient; 95%-CI, 95%- confidence interval; *linearly transformed on a scale from 0 (negative/low) to 100 (positive/high)
To cite this abstract in AMA style:
Kuipers JG, Koller M, Zeman F, Mueller K, Rueffer JU. Disability (HAQ) and Quality of Life (SF-12) As Related to Adherence and Health Literacyin Patients with Rheumatoid Arthritis – the Trace-Study [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/disability-haq-and-quality-of-life-sf-12-as-related-to-adherence-and-health-literacyin-patients-with-rheumatoid-arthritis-the-trace-study/. Accessed .« Back to 2017 ACR/ARHP Annual Meeting
ACR Meeting Abstracts - https://acrabstracts.org/abstract/disability-haq-and-quality-of-life-sf-12-as-related-to-adherence-and-health-literacyin-patients-with-rheumatoid-arthritis-the-trace-study/