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医患评估不一致与皮下生物制剂不依从。

Discordance between doctor and patient assessments and non-adherence to subcutaneous biological drugs.

机构信息

Instituto de Salud Musculoesquelética (Inmusc), Calle Conde de la Cimera, 6, 28040, Madrid, Spain.

Servicio de Reumatología, Hospital Can Misses, Ibiza, Spain.

出版信息

Rheumatol Int. 2019 Jun;39(6):1077-1082. doi: 10.1007/s00296-019-04304-w. Epub 2019 Apr 16.

DOI:10.1007/s00296-019-04304-w
PMID:30989332
Abstract

To estimate the agreement level between patient and physician assessment of disease activity and to explore whether agreement is associated with adherence to subcutaneous (SC) biological drugs in rheumatoid arthritis (RA). Cross-sectional study of RA patients who had been prescribed a SC biological drug in the past 12-18 months was performed. Patients and physicians global disease activity on visual analogue scale (VAS) were collected. Disagreement was defined as an absolute difference ≥ 3 points between VAS scores. Adherence was assessed by the Medication Possession Ratio (MPR), considering adherence an MPR > 80%. We analysed 360 patients of whom 15.5% presented disagreement with their physicians. The mean patient global VAS was 5.75 ± 1.8 (median 5.5 [5-7]) in the disagreement group versus 2.7 ± 2.2 (median 2 [1-4]) in the agreement group (p < 0.001). There were also differences in physicians global VAS between groups (p = 0.01). The non-adherence to SC biological drugs rate was 10.7% and 14.5% in the disagreement and agreement groups (p = 0.45). No association between adherence and discordance was found. Disagreement in the global disease activity between patients and physicians was detected in 15.5% of patients. In general, patients perceived higher disease activity. No associations between patient-physician disagreement in VAS and adherence were observed.

摘要

评估患者和医生对疾病活动的评估之间的一致性水平,并探讨这种一致性是否与类风湿关节炎(RA)患者皮下(SC)生物药物的依从性有关。对过去 12-18 个月内开处方 SC 生物药物的 RA 患者进行了横断面研究。收集了患者和医生的视觉模拟量表(VAS)的整体疾病活动评分。VAS 评分的绝对差值≥3 点定义为不一致。通过药物占有比(MPR)评估依从性,将 MPR>80%定义为依从性。我们分析了 360 名患者,其中 15.5%的患者与医生意见不一致。在不一致组中,患者的全球 VAS 平均值为 5.75±1.8(中位数 5.5[5-7]),而在一致组中为 2.7±2.2(中位数 2[1-4])(p<0.001)。两组间医生的全球 VAS 也存在差异(p=0.01)。不一致组和一致组 SC 生物药物不依从率分别为 10.7%和 14.5%(p=0.45)。未发现依从性与不一致之间存在关联。在 15.5%的患者中检测到患者和医生之间的整体疾病活动存在不一致。一般来说,患者感知到更高的疾病活动。未观察到 VAS 患者-医生不一致与依从性之间存在关联。

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本文引用的文献

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Adherence and dosing interval of subcutaneous antitumour necrosis factor biologics among patients with inflammatory arthritis: analysis from a Canadian administrative database.炎症性关节炎患者皮下注射抗肿瘤坏死因子生物制剂的依从性和给药间隔:来自加拿大管理数据库的分析
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