Session Information
Session Type: Abstract Submissions (ARHP)
Background/Purpose : Treatment adherence is a crucial part of successfully managing rheumatic diseases such as Rheumatoid Arthritis (RA). Low adherence to treatment has been related to poor radiographic and clinical outcomes in these patients. The aim of our study was to determine the prevalence and factors associated with non-adherence in patients with RA.
Methods : We designed a multicenter cross sectional study. Consecutive patients with RA (ACR’87 and or ACR/EULAR 2010) were recruited from 7 rheumatology clinics. Data collected included comorbidities, demographic and clinical variables. Patient-reported clinical outcomes included the Clinical Disease Activity Index (CDAI) and the Health Assessment Questionnaire (HAQ). Adherence to treatment was assessed using the Compliance Questionnaire Rheumatology (CQR; 0 – 100, 0 low adherence). Patients were categorized as having low or acceptable adherence using the traditional cutoff (≤80). Frequencies and distribution of adherence were calculated. The association between adherence and clinical/demographic variables were assessed using univariate and multivariate models.
Results : Three hundred and thirty-eight patients were included, 84 % were female, mean age was 53 ± 12 years, disease duration 13 ± 10 years, CDAI 13 ± 11 and HAQ 1.00 ± 0.75. Mean adherence to the treatment regimen as determined by CQR score was 86 ± 10. Two hundred and sixty-two patients (81%) had acceptable level of adherence. These patients had significantly higher age (p=0.03), higher level of education (p=<0.01), were more frequently unemployment (p=0.03), and had longer disease duration (p=<0.01). After adjusting for multiple confounders, only longer disease duration (OR= 1.1, CI95%=1.01-1.08, p =0.04) and live alone (OR= 0.3, CI95%=0.1-0.6, p = <0.01) remained significantly associated with acceptable adherence (Table 1).
Conclusion : In our population, only one fifth of patients with RA showed low self-reported adherence to treatment. These patients had shorter disease duration and more frequently live alone. Physicians must be aware of patients at high risk of low treatment adherence in order to avoid long-term consequences.
Table 1
|
Logistic regression using level of adherence as dependent variable (CQR ≥80 =1; CQR <80 =0) |
|||
|
OR |
95% Confidence interval |
p- value |
|
|
Age (years) |
1.02 |
0.99 – 1.05 |
0.10 |
|
Female |
0.90 |
0.39 – 2.09 |
0.81 |
|
Disease duration (years) |
1.04 |
1.00 – 1.08 |
0.04 |
|
Years of education |
1.02 |
0.95 – 1.11 |
0.54 |
|
Number of comorbidities |
1.2 |
0.81 – 1.89 |
0.33 |
|
Live alone |
0.26 |
0.11 – 0.61 |
0.002 |
|
CDAI |
1.00 |
0.97 – 1.04 |
0.79 |
|
HAQ |
1.27 |
0.74 – 2.21 |
0.38 |
Disclosure:
M. C. Orozco,
None;
M. F. Marengo,
None;
C. A. Waimann,
None;
A. I. Marcos,
None;
A. Granel,
None;
S. Velez,
None;
F. Zazzetti,
None;
J. C. Barreira,
None;
P. Kohan,
None;
O. L. Rillo,
None;
M. V. Collado,
None;
G. Gómez,
None;
R. V. Juárez,
None;
V. Lencina,
None;
A. D’Orazio,
None;
G. Rodriguez Gil,
None;
M. Salcedo,
None;
G. Citera,
None.
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