ADHERENCE TO BIOLOGIC DRUGS AMONG PATIENTS WITH IMMUNE MEDIATED INFLAMMATORY DISEASES IN DUHOK GOVERNORATE

HALA F. KASIM; HISHYAR M. SALIH; SOUZAN H. EASSA

HALA F. KASIM Asis. Lecturer, Department of Clinical Pharmacy, College of the Pharmacy, University of Mosul, Mosul, Iraq.
HISHYAR M. SALIH Lecturer, Department of Clinical Pharmacy, College of the Pharmacy, University of Duhok,
SOUZAN H. EASSA Assistant Prof, Department of Anatomy and Biology, College of Medicine, University of Duhok, Kurdistan Region, Iraq.

Keywords: Adherence, biological drugs, medication adherence scale

Abstract

https://doi.org/10.31386/dmj.2020.4.1.7

Background: The need for ongoing treatment to manage immune-mediated inflammatory diseases is a challenge for health care providers, as there is always an attempt to achieve clinical remission as much as possible.

Objective: This study aimed to estimate the prevalence of non-adherence to biological drugs and factors affecting it among patients in Duhok governorate-Iraq.

Patients and Methods: A cross-sectional questionnaire-based study was conducted between December 2018 to October 2019 at the specialized center of rheumatic disease and medical rehabilitation in Duhok city. One hundred forty-four patients who lived in Duhok governorate out of 216 registered cases were included, each with the established disease for at least 12 months, and had been taking biological drugs (Etanercept, Infliximab, and Adalimumab) with or without conventional drugs for at least three months were involved in this study. Disease activity scales as appropriate to each disease were used, with using a medication adherence scale to assess the adherence to medications.

Results: From the total of 144 patients included in this study, 134 (93.1%) of them were non-adherent compared to only 10 (6.9%) of patients who were adherent to medication intake. Significant associations existed between adherence to the medications and different factors. These factors with the corresponding percentages of non-adherence were as follows: age between 30-39 (34.3%), illiterate/ primary education (56.0%), unemployed (64.9%), no ability to buy biologic drugs (82.1%), etanercept users (71.6%) and (56.7%) were using biological drugs for less than four years.

Conclusion and recommendation: With the existence of multiple factors effect on adherence to medications and due to the inconsistency of these factors, routine measurements of adherence to medications are essential in achieving the desired therapeutic goal.

Downloads

Download data is not yet available.

References

1. Vangeli E, Bakhshi S, Baker A, Fisher A, Bucknor D, Mrowietz U, et al. A systematic review of factors associated with non-adherence to treatment for immune-mediated inflammatory diseases. Advances in therapy. 2015; 32(11): 983-1028.
2. Michetti P, Weinman J, Mrowietz U, Smolen J, Peyrin-Biroulet L, Louis E, et al. Impact of treatment-related beliefs on medication adherence in immune-mediated inflammatory diseases: Results of the Global ALIGN study. Advances in therapy. 2017; 34 (1): 91-108.
3. Lavielle M, Puyraimond-Zemmour D, Romand X, Gossec L, Senbel E, Pouplin S, et al. Methods to improve medication adherence in patients with chronic inflammatory rheumatic diseases: A systematic literature review. RMD Open. 2018; 4(2): e000684.
4. Rincón-Rincón JR, Jaimes Fernández DA, García-Casallas JC, Beltránd A, Télleze A, Fernández-Ávila DG, et al. Methods for measuring adherence to oral disease-modifying drugs in rheumatoid arthritis and factors associated with low adherence to pharmacological treatment.Revista Colombiana de Reumatología. 2018; 25(4): 261-270.
5. Salt E, Frazier SK. Predictors of medication adherence in patients with rheumatoid arthritis. Drug development research. 2011; 72(8): 756-63.
6. Van Den Bemt BJ, Zwikker HE, van den Ende CH. Medication adherence in patients with rheumatoid arthritis: A critical appraisal of the existing literature. Expert Review of Clinical Immunology. 2012; 8(4): 337-51.
7. Lehmann A, Aslani P, Ahmed R, Celio J, Gauchet A, Bedouch P, et al. Assessing medication adherence: Options to consider. International journal of clinical pharmacy. 2014; 36(1): 55-69.
8. Anderson J, Caplan L, Yazdany J, Robbins ML, Neogi T, Michaud K, et al. Rheumatoid arthritis disease activity measures: American college of rheumatology recommendations for use in clinical practice. Arthritis care & research. 2012; 64(5): 640-7.
9. Sehgal R, Koltun WA. Scoring systems in inflammatory bowel disease. Expert review of gastroenterology & hepatology. 2010; 4(4): 513-21.
10. Lewis JD, Chuai S, Nessel L, Lichtenstein GR, Aberra FN, Ellenberg JH. Use of the noninvasive components of the Mayo score to assess clinical response in ulcerative colitis. Inflammatory bowel diseases. 2008; 14(12): 1660-6.
11. MDCalc: Patient Activity Scale II (PAS II) for RA [Internet]. U.S.: Medical calculator; c2005-2019 [cited 2019 July 1]. Available from: https://www.mdcalc.com/patient-activity-scale-ii-pas-ii-ra#evidence.
12. IG-IBD: Calculators in gastroenterology [Internet]. Florence (Italy): The Italian group for inflammatory bowel disease; [cited 2019 July 20]. Available from: https://www.igibdscores.it/en/score-cdai.html
13. Guillemin F, Bombardier C, Beaton D. Cross-cultural adaptation of health-related quality of life measures: literature review and proposed guidelines. Journal of clinical epidemiology. 1993; 46(12): 1417-32.
14. Wild D, Grove A, Martin M, Eremenco S, McElroy S, Verjee-Lorenz A, et al. Principles of good practice for the translation and cultural adaptation process for patient-reported outcomes (PRO) Measures: report of the ISPOR task force for translation and cultural adaptation. Value in Health. 2005; 8(2): 94-104.
15. Del Greco L, Walop W, Eastridge L. Questionnaire development: 3. Translation. CMAJ: Canadian Medical Association Journal. 1987; 136(8): 817-8.
16. Mikhael EM, Hussain SA, Shawky N, Hassali MA. Validity and reliability of anti-diabetic medication adherence scale among patients with diabetes in Baghdad, Iraq: a pilot study. BMJ Open Diabetes Research and Care. 2019; 7(1): 1-7.
17. Marengo MF, Suarez-Almazor ME. Improving treatment adherence in patients with rheumatoid arthritis: what are the options?.International journal of clinical rheumatology. 2015; 10(5): 345-56.
18. Goh H, Kwan YH, Seah Y, Low LL, Fong W, Thumboo J. A systematic review of the barriers affecting medication adherence in patients with rheumatic diseases. Rheumatology international. 2017; 37(10): 1619-628.
19. Gadallah MA, Boulos DNK, Dewedar S, Gebrel A, Morisky DE. Assessment of rheumatoid arthritis patients' adherence to treatment. The American journal of the medical sciences. 2015; 349(2): 151-6.
20. Alhefny AE, Abd El-Rahman M, Abd El-Moteleb S, Sakr H, Hassan R. Evaluation of adherence to drug treatment in patients with rheumatoid arthritis. Egyptian Journal of Rheumatology and Clinical Immunology. 2016; 4(1): 68-80.
21. Berner C, Erlacher L, Fenzl KH, Dorner TE. Medication adherence and coping strategies in patients with rheumatoid arthritis: A cross-sectional study. International Journal of Rheumatology. 2019; 2019:1-8.
22. Dabaghian FH, Rassouli M, Sadighi J, Ghods R. Adherence to prescribed medications of Iranian traditional medicine in a group of patients with chronic disease. Journal of research in pharmacy practice. 2016; 5(1): 52-7.
23. Sharma S, Roshi, Tandon VR, Mahajan A. A study evaluating adherence and compliance of anti-rheumatic drugs in women suffering from rheumatoid arthritis. Journal of clinical and diagnostic research. 2015; 9(11): 1-4.
24. Xia Y, Yin R, Fu T, Zhang L, Zhang Q, Guo G, et al. Treatment adherence to disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis. Patient preference and adherence. 2016; 10: 735-42.
25. Murage MJ, Tongbram V, Feldman SR, Malatestinic WN, Larmore CJ, Muram TM, et al. Medication adherence and persistence in patients with rheumatoid arthritis, psoriasis, and psoriatic arthritis: a systematic literature review. Patient preference and adherence. 2018; 12:1483-503.