AB0306 Predictors of medication adherence in serbian patients with rheumatoid arthritis

Background Adherence to pharmacologic therapy is a significant problem in patients with rheumatoid arthritis (RA). Nonadherence in patients with RA using disease modifying antirheumatic drugs (DMARD) may result in unnecessarily high levels of disease activity and function loss. Objectives The aim of this study was to evaluate the predictive ability of demographic (age, sex, marital status, employment status, education) and clinical factors (duration of disease, patients assessment of pain, concomitant use of biological therapy and presence of comorbidity) for medication adherence. Methods In the period between March 1 and May 30, 2017, 195 consecutive RA patients who were treated in one of three randomly chosen Serbian clinics were enrolled in cross-sectional study. The inclusion criteria were: age ≥18 years, current diagnosis of RA per the 1987. ACR Diagnostic Criteria, completing the questionnaire self-reported medication adherence and written informed consent. Demographic and clinical characteristics of adherent and non-adherent participants were compared using independent samples t-tests for continuous variables and Chi square analyses for categorial variables. The associations between investigated demographic and clinical characteristics of the patients and non-adherence to DMARDs were assessed applying logistic regression analysis. Results Study population was predominantly female (88%), and the average current age was 57.4±11.2 years. The median duration of RA was 9 years. Only one quarter (25%) of participants were employed, those unemployed 26% or retired (48%) comprised the majority of the sample. In terms of education approximately 60% participants finished secondary school. The participants in this study were primarily married (77%). The majority of the patients were prescribed methotrexate (77%), other common DMARDs prescribed for these patients included hydroxychloroquine (13%) and prednisone (18%). Approximately 20% of patients were receiving a biological drug. Half of the patients estimated that they had severe pain on visual analogue scale (VAS >5). The majority of the RA patients had some comorbidity (80%). The most of these RA patients (89.7%) were considered adherent to medication prescriptions and the remainder (11.3%) were non-adherent. There were no significant difference in clinical or demographic factors between groups except for employment and concomitant use of biological therapy. One third (33.3%) of the non-adherent participants were using biologic drug, while only 19% of the adherent patients were using biologics. There were significantly more employees (29%) among the non-adherent patients. According to the results of univariate regression analysis the following factors are significantly associated with non-adherence to DMARDs: employment (OR=2.277; p=0.049), and concomitant use of biological therapy (OR=2.312; p=0.002). Finally, in the multivariate regression model concomitant use of biological therapy (OR=2.067; p=0.017) remained statistically significant and was identified as independent predictor of non-adherence to DMARDs. Conclusions The results of our study have shown that about 10% of RA patients met the criteria for non-adherence to DMARDs. Concomitant use biologics and employment are independent predictors of non-adherent. Disclosure of Interest None declared