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类风湿关节炎患者对生物制剂的依从性、恐惧及信念:一项北非试点研究。

Adherence, Fears, and Beliefs about Biologic Drugs in Rheumatoid Arthritis Patients: A North African Pilot Study.

作者信息

Boussaid Soumaya, Hannech Emna, Rekik Sonia, Rahmouni Safa, Zouaoui Khaoula, Abbes Maissa, Sahli Hela, Elleuch Mohamed, Ben Saad Helmi

机构信息

Rheumatology Department, La Rabta Hospital, Tunis, Tunisia.

Faculty of Medicine of Tunis, University Tunis el Manar, Tunis, Tunisia.

出版信息

Mediterr J Rheumatol. 2024 Dec 31;35(4):623-633. doi: 10.31138/mjr.200823.afa. eCollection 2024 Dec.

Abstract

PURPOSE

To investigate the impact of beliefs in adherence to biologic drugs among patients with rheumatoid arthritis (RA).

METHODS

This was a cross-sectional study, including RA patients who were on biologic disease-modifying antirheumatic drugs (bDMARDs). Therapeutic adherence was evaluated arbitrarily using a self-reported method by asking them the following question: "Do you regul arly take your biologic drug as prescribed by your doctor?". The Beliefs about Medicines Questionnaire (BMQ) was used to evaluate medication beliefs [general overuse, general harm, specific necessity, specific concerns].

RESULTS

Seventy-five RA patients were included (80.0% females, 33.3% illiterate, and 68.0% unemployed, mean age: 57±9 years, mean disease activity score: 3.94±1.32). Adherence to the current biologic drug was reported by 71 patients (94.7%). The means ± standard deviation scores for general overuse, general harm, specific necessity, and specific concerns were 14.0±2.4, 10.8±4.4, 20.6±5.7, and 10.3±3.3, respectively. Compared to the adherent group (n=71), the non-adherent group (n=4) had a lower specific necessity score (21.0±5.4 vs. 13.5±7.5, respectively, p=0.009), a higher specific concern score (10.1±3.13 vs. 15.0±2.8, respectively, p=0.036), and similar scores for general overuse and general harm (10.0±2.3 vs. 9.5±1.9, p=0600; 13.3±4.4 vs. 11.5±4.1, p=0.400, respectively). In logistic regression, specific necessity and specific concerns scores were significantly associated with adherence (Odds-ratio (OR)= 0.855, 95% confidence interval (CI) [0.726-1.006], and 1.438, 95% CI [1.004-1.980], respectively).

CONCLUSION

Our study showed that RA patients have strong beliefs about the necessity to take biologic drugs which significantly influence the adherent behaviour therapy.

摘要

目的

探讨类风湿关节炎(RA)患者对生物制剂治疗依从性的信念影响。

方法

这是一项横断面研究,纳入正在使用生物改善病情抗风湿药物(bDMARDs)的RA患者。通过询问患者以下问题,采用自我报告法随意评估治疗依从性:“你是否定期按医生处方服用生物制剂?”。使用药物信念问卷(BMQ)评估用药信念[一般过度使用、一般危害、特定必要性、特定担忧]。

结果

纳入75例RA患者(女性占80.0%,文盲占33.3%,失业占68.0%,平均年龄:57±9岁,平均疾病活动评分:3.94±1.32)。71例患者(94.7%)报告了对当前生物制剂的依从性。一般过度使用、一般危害、特定必要性和特定担忧的平均±标准差得分分别为14.0±2.4、10.8±4.4、20.6±5.7和10.3±3.3。与依从组(n = 71)相比,非依从组(n = 4)的特定必要性得分较低(分别为21.0±5.4和13.5±7.5,p = 0.009),特定担忧得分较高(分别为10.1±3.13和15.0±2.8,p = 0.036),一般过度使用和一般危害得分相似(10.0±2.3和9.5±1.9,p = 0.600;13.3±4.4和11.5±4.1,p = 0.400)。在逻辑回归中,特定必要性和特定担忧得分与依从性显著相关(优势比(OR)分别为0.855,95%置信区间(CI)[0.726 - 1.006],以及1.438,95% CI [1.004 - 1.980])。

结论

我们的研究表明,RA患者对服用生物制剂必要性有强烈信念,这对治疗依从行为有显著影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e0d1/11778605/e9d175cf02f0/MJR-35-4-623-g001.jpg

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