Collection of Anti-Rheumatic Medication Data from Both Patients and Rheumatologists Shows Strong Agreement in a Real World Clinical Cohort: The Ontario Best Practices Research Initiative (OBRI) a Rheumatoid Arthritis Cohort

Abstract Objectives To examine the agreement between patient and rheumatologist reported Anti-Rheumatic Medication (ARM) use in the Ontario Best Practices Research Initiative (OBRI). Study Design and Setting We included adult patients who enrolled on or after Sep 1 st 2010 and compared ARM use where rheumatologist visits and interviews occurred within 60 days of each other. Kappa statistic was used to measure agreement. We calculated sensitivity, specificity, positive, and negative predictive value, considering patient reported data as the gold standard. To examine factors associated with agreement, a hierarchical generalized linear model was used. A subset analysis was also completed to compare start and stop dates of ARM. Results Overall agreement for ARM was good with higher sensitivity and lower specificity for csDMARDs compared with bDMARDs. Increased Health Assessment Questionnaire (HAQ) pain index and disease activity score (DAS)28-ESR were significantly associated with lower agreement. Reporting stop dates was higher (19.4%) for patient reported data compared to rheumatologist reported data (13.1%). Conclusion ARM reports had strong agreement particularly for patients who have low disease activity and pain. ARM discontinuation were reported more frequently by patients which may indicate that patients may be discontinuing use of their RA medications prior to consulting their rheumatologist.