1. 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

2. 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

3. 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.

4. 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

5. Absolute Value and Percentage
Results No. of Cases
Absolute Value and Percentage
Fig. 1 Demographic statistics

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

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

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

9. 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

10. 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

11. 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

12. 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

13. 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

14. 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.