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Clin Exp Rheumatol. 2021 May 28; Epub 2021 May 28.

Adherence to and patient's knowledge of self-management of subcutaneous biologic therapy in chronic inflammatory rheumatic diseases: results of a multicentre cross-sectional study.

Clinical and experimental rheumatology

Veronique Gaud-Listrat, Clementina Lopez-Medina, Christophe Hudry, Minh Nguyen, Agnes Lebrun-Foisnet, Antoinette Sacchi, Sylvain Labatide Alanore, Emmanuelle Dernis, Patricia Le Devic, Jacques Fechtenbaum, Corinne Richard-Miceli, Patrick Le Goux, Sabrina Dadoun, Anna Moltό, Anne Blanchais-Behr, Severine Neveu, Mathilde Benhamou, Bernard Giraud, Christian Roux, Maxime Dougados,

Affiliations

  1. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and Office based in Saint Michel sur Orge, France. [email protected].
  2. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and INSERM (UMR1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France, and University of Cordoba/IMIBIC/Reina Sofia Hospital, Cordoba, Spain.
  3. Office based in Paris, and CeSOA MGEN action sociale, Paris, France.
  4. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and Office based in Paris, France.
  5. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris; Office based in Paris, and CeSOA MGEN action sociale, Paris, France.
  6. Department of Rheumatology, Hôpital de Mantes la Jolie, Mantes-la-Jolie, France.
  7. Office based in Paris, and Department of Rheumatology, Hôpital la Croix St Simon, Paris, France.
  8. Department of Rheumatology, Centre Hospitalier du Mans, Le Mans, France.
  9. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and Office based in Montigny le Bretonneux, France.
  10. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and Office based in Pantin, France.
  11. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and INSERM (UMR1153): Clinical Epidemiology and Biostatistics, PRES Sorbonne Paris-Cité, Paris, France.
  12. Office based in Puteaux, and Department of Rheumatology, Hôpital Ambroise Pare, Boulogne-Billancourt, France.
  13. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and CeSOA MGEN action sociale, Paris, France.
  14. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and Office based in Gif sur Yvette, France.
  15. Department of Rheumatology - Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, and Office based in Meudon, France.
  16. Department of Re-education, Hôpital Cochin, Paris, and Office based in Versailles, France.
  17. Office based in Gif sur Yvette, and Department of Re-education, Hôpital Cochin, Paris, France.

PMID: 34128794

Abstract

OBJECTIVES: Non-adherence to biologic therapy is an issue in chronic inflammatory rheumatic diseases (CIRDs) and might be related to poor patient knowledge of the risk of these therapies. Our aim here was to evaluate the level of patient adherence to and knowledge of self-care safety skills for biologic therapy.

METHODS: This was a multicentre, cross-sectional study in which out-patients visited an office- or hospital-based rheumatologist. All the patients received subcutaneous biologic therapy for CIRDs. We collected data on: 1. the level of CIRD patient adherence to current subcutaneous biologic therapy using both the self-administered Compliance Questionnaire Rheumatology 5 items (CQR5) and a simple adherence question; 2. patients' knowledge of self-management of biologic therapy by the self-administered BIOSECURE questionnaire; 3. sources of information related to biologic therapy.

RESULTS: In all, 285 patients (rheumatoid arthritis, n=103; spondyloarthritis, n=153; psoriatic arthritis, n=25) were enrolled by 19 rheumatologists. The mean (SD) biologic therapy duration was 5.9 (4.9) years. Adherence to the current biologic therapy was high (79.3% and 57.5% according to the CQR5 questionnaire and the adherence question, respectively). Level of knowledge of self-care safety skills (median BIOSECURE score 71) was in the acceptable range. Level of adherence and level of knowledge of self-care safety skills for biologic therapy were not associated. Patients declared that the main sources of information were their rheumatologist (92.6%) and the rheumatology team (30.5%).

CONCLUSIONS: According to the patients' estimation, adherence to biologic therapy and the level of knowledge of self-care safety skills related to biologic therapy are acceptable, and these domains are not related (e.g. level of adherence and level of knowledge of risks).

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