The Adherence to Treatment Regarding of the Patients with

Rheumatoid Arthritis

Ana-Maria Toma (Gabor), Estera Gabor

6th year – Faculty of Medicine

Scientific supervisor: Monica Copotoiu, MD, PhD

Motto

“Drugs don’t work in patients who don’t take them.” C. Everett Koop M.D.- Medication Adherence and Chronic Disease Management, Cynthia Jackevicius, National Conference of State Legislatures,December 2009;28

Introduction

• Understanding that non-adherence to treatment is a real problem in nowadays medical structure.

• Identifying adherence problems concerning the treatment of patients diagnosed with rheumatoid arthritis – an invalidating disease.

• Identify related factors to non-adherence to treatment in rheumatoid arthritis.

Material and methods

Questionnaire

Patients with rheumatoid arthritis hospitalized in the Rheumatology Clinic of Emergency County Hospital of Târgu Mureş between 1st July and 1st October 2013

ResultsNo. of Cases

Absolute Value and Percentage

Fig. 1 Demographic statistics

Results

Fig. 2 Adherence based on the situation when patients felt better with the prescribed medication

Results

Fig. 3 Adherence based on the situation when patients felt worse with the prescribed medication

Results

Fig. 4 Distribution regarding the patients financial level based on their easiness for coming to regular monitoring

Results No. Related factors Prefered answers Alternative answers

1 Information sources 90% - rheumatologist recomandations

10% - other sources

2 Natural therapy 72% - prefer the allopathic therapy

28% - would try a natural therapy

3 Understanding the medication importance

84% - the doctor explained

16% - did not understood or the

doctor did not explained4 The reading impact

of medication prospectus

82% - followed the doctor indications after reading the

prospectus

18% - stopped the medication after reading

5 Other methods preferred instead of

prescribed medication

86% - would follow doctor indications

14% - would give up medication instead of a

healthy lifestyle and physical therapy

Results No. Related factors Prefered answers Alternative answers

6 Psychological status 80% - without problems

20% - felt anxious or depressed related to their

disease

7 Confidence in medical system

96% - yes 4% - no

8 Doubt regarding the efficiency of the

medication

84% - consider the treatment useful

16% - medication is on long running and it might be

useless

9 The Romanian medical system’s quality level

72% - consider they have access to quality

health servicies

28% - Romanian medical system does not offer quality health servicies

10 Health status influenced by the administrated

medication (side effects)

66% - believe that the medication offers more

benefits than risks

34% - consider that medication worsened their

health status because of drugs’ side effects

Results

Fig. 6 The patients’ incidence regarding adherence to treatment in the situation when they have considered they have felt better, compared by age

Results

Fig. 7 The patients’ incidence regarding adherence to treatment in the situation when they have considered they have felt better, compared by environment of origin

P=0,75

Results

p=0.001; RR=2,08; 95%IC=1,29-3,33

Fig. 8 The patients’ incidence regarding adherence to treatment in the situation when they have considered they have felt better, compared by years from diagnosis

Conclusions• The young adults (18-60 years old), despite

their education, are less adherent to treatment.

• The adherence to treatment of the over 60 years patients is due to their paternalism relation with the physician.

• A long onset of the disease is a factor that predicts a less adherence to the medical treatment in rheumatoid arthritis.