AB0342 EVALUATION OF SELF-CARE SAFETY SKILLS AND THERAPEUTIC KNOWLEDGE OF RHEUMATOID ARTHRITIS PATIENTS ON BIOLOGIC DRUGS

Abstract

BackgroundThe management of rheumatoid arthritis (RA) was revolutionized by the use of biologic therapies (bDMARD). Nevertheless, bDMARDs may carry some specific risks such as infection. However, data about self-care safety skills are poor [1]. An assessment of the level of information and education is therefore essential for patients followed for RA.ObjectivesThe purpose of our study was to assess knowledge and safety skills of RA patients under bDMARDs.MethodsWe conducted a descriptive, bi-centric, and cross-sectional study, including RA patients receiving intravenous (IV) or subcutaneous (SC) bDMARD for at least 3 months. Sociodemographic, clinical, and paraclinical data were collected. Knowledges and self-care safety skills were assessed by a pre-specified questionnaire.The questionnaire was divided into three domains:- Five questions about general theoretical knowledge domain: assessing patient’s knowledge of the name of the current bDMARD, duration and rate of intake, and a question on annual cost estimation.- Three questions about the current bDMARD management: assessing cold chain compliance and management of the biologic in SC emphasizing adherence to the steps to be taken prior to giving the injection.- Tow questions about knowledge regarding safety skills in special situations: infection, cough, contraception, surgery, vaccination, and regarding the need to inform others about the use of bDMARD.Based on the data analysis, patients were divided into 3 groups according to their knowledge level:- Group A (low knowledge level: percentage of correct answers <40%)- Group B (moderate knowledge level: percentage of correct answers >40% and <60%)- Group C (high level of knowledge: percentage of correct answers > 60%).ResultsSeventy-five patients with RA were collected. Their mean age was 56.92 ± 9.06 years [34-80]. The mean duration of bDMARD was 37.17 ± 39.44 months [4-248] with a mean rank of 1.41 ± 0.9 [1-5]. The SC route was used in 41 patients (54.7%) followed by the IV route in 34 patients (45.3%)The most prescribed molecules were Infliximab, Certolizumab and Tocilizumab (22.7% respectively). The average order of the current biologics was 1.41 ± 0.9 [1-5] in combination with a csDMARD in 48 patients (64%).Safety skills were low in 24 patients (32%), moderate in 36 patients (48%), and high in 15 patients (20%).The mean percentage of correct answers for each domain was respectively: 56.53 ± 18.4% [20-100] for general theoretical knowledge domain, 68.44 ± 26.21% [0-100] for the management of current biologic treatment domain, and 40.8 ± 16.87% [6.67-80] for knowledge regarding safety skills in special situations.Safety skills levels were significantly related to occupational status (p=0.001), DAS28 CRP (p=0.04), joint deformities (p=0.01) and radiographic erosions (p=0.006), number of previous bDMARDs (p=0.009), and the rank of the current bDMARD (p=0.009).ConclusionThe major finding of our study was the insufficient level of knowledge and safety skills of RA patients under bDMARDs. We highlight the importance of involving patients in the decision-making process and emphasize the role of the therapeutic patient education programs.References[1]Orefice D, Beauvais C, Gossec L, Flipon E, Fautrel B, Marguerie L, et al. Cross-sectional study of self-care safety skills in 677 patients on biodrugs for inflammatory joint disease. Joint Bone Spine. 2014;81(6):502‑7Disclosure of InterestsNone declared