AB1346\u2005PATIENTS’ BELIEFS ABOUT MEDICINES PRESCRIBED FOR THEIR RHEUMATOID ARTHRITIS OR SPONDYLOARTHRITIS

Abstract

Background Adherence to therapies is determined by multiple factors, some of which are patient’s related and include economic resources, knowledge, attitudes, beliefs, perceptions and expectations about medication. Objectives To assess patients’ beliefs about prescribed medication for their rheumatic disease (rheumatoid arthritis (RA) or spondyloarthritis (SpA), including psoriatic arthritis) and to determine the existence of any association between these beliefs and clinical and socio-demographic variables. Methods Observational cross-sectional study which included RA patients according to 1987 ACR and/or 2010 ACR/EULAR criteria and SpA patients according to 2009 ASAS classification criteria (CC) for axial SpA or to 2011 ASAS CC for peripheral SpA, on subcutaneous biological therapy, followed at our Center, able to complete questionnaires autonomously and who agreed to participate. Socio-demographic and clinical data, anxiety and depression through the Hospital Anxiety and Depression Scale (HADS) and fatigue using the Functional Assessment of Chronic Illness Therapy - Fatigue questionnaire (FACIT-F) were collected. To assess beliefs about medication, the cross-culturally adapted Portuguese version of the Beliefs about Medicines Questionnaire (BMQ)-Specific was used, asking patients to apply it considering only the prescribed medicines for AR or SpA. The BMQ-Specific comprises two subscales: a five-item Necessity scale (Specific-Necessity, SN) and a six-item Concerns scale (Specific-Concerns, SC). Each item is scored on a five-point Likert scale (from 1 = strongly disagree to 5 = strongly agree). Statistics: descriptive, Mann-Whitney and Kruskal-Wallis tests and Spearman correlation, p <0.05.Abstract AB1346 Table 1 Descriptive statistics of the continuous variables of the RA and SpA patients RA patients SpA patients Median (IQR) Median (IQR) Current age - years 60,0 (51,0-66,0) 47,0 (39,5-57,0) Disease duration – years 14,5 (12,0-18,3) 13,0 (8,0-19,0) Time on treatment with the current biologic therapy – months 31,0 (20,0-62,0) 37,0 (12,0-83,0) PGA 32,0 (6,0-55,0) 29,0 (14,5-51,5) VAS pain 41,0 (21.0-60.0) - PhGA 19,5 (6,5-33,8) 12,5 (5,0-23,5) Nocturnal back pain VAS - 17,0 (4,5-34,0) Back pain VAS - 18,0 (5.5-43,0) VS – mm/H 15,0 (7,0-30,5) 7,0 (2,0-14,0) CRP – mg/dL 0,2 (0,1-0,6) 0,3 (0,1-1,0) DAS28_4 V 3,2 (2,4-4,4) - BASDAI - 2,8 (1,1-4,6) ASDAS - 1,8 (1,1-2,4) BASMI - 2,7 (2,1-4,0) HAQ 0,8 (0,4-1,2) - BASFI - 1,8 (0,7-3,7) BMQ-SN 17,0 (15,0-18,0) 16,0 (15,0-18,0) BMQ-SC 18,0 (15,0-22,0) 18,0 (13,5-22,0) Results We obtained data from 84 patients, 45 SpA (53.6%) and 39 (46.4%) RA patients. Table 1 presents the descriptive statistics of the continuous variables. In RA group, 92.3% were female, 84.6% under anti-TNF, 66.7% under their 1st biologic and we found an association between BMQ-SC score and HADS-anxiety (p=0.013) and positive correlations between BMQ-SC score and Patient Global Assessment (PGA) (p=0.031), VAS pain (p=0.004), Physician’s Global Assessment (PhGA) (p=0.004), DAS28 (p=0.007), and HAQ (p <0.001). In SpA group, 62.2% were female, 86.7% under anti-TNF, 77.8% under their 1st biologic and BMQ-SN score was positively correlated with VAS nocturnal back pain (p=0.047), PhGA (p=0.045) and BASFI (p=0.003). Conclusion In RA patients, those with higher disability and a clinically more active disease presented higher levels of concern regarding the medication. In SpA, patients with a more aggressive disease, with nocturnal pain and worse function have a stronger conviction of the necessity and efficacy of the medication. References [1] Salgado T, Marques A, Geraldes L, Benrimoj S. Horne R. Fernandes-Llimos F. Cross-cultural adaptation of the Beliefs about Medicines Questionnaire into Portuguese. Sao Paulo Med J. 2013; 131(2):88-94. doi:10.1590/S1516-31802013000100018. Disclosure of Interests Nathalie Madeira: None declared, Candida Silva: None declared, Claudia Miguel: None declared, Dina Medeiros: None declared, Filipe Barcelos Consultant for: Pfizer; Ely-Lilly, Speakers bureau: Novartis, Helena Santos: None declared, Ricardo Trinca: None declared, Alexandra Cardoso: None declared, Luís Cunha Miranda: None declared