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

Absolute Value and Percentage Results No. 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 Information sources 90% - rheumatologist recomandations 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 explained 4 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 Quite interesting is that in the 5th decade a high percentage of females ranging from 31 to 40 years died of hepatic cirrhosis. Fig. 6 The patients’ incidence regarding adherence to treatment in the situation when they have considered they have felt better, compared by age

Results P=0,75 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

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.