The impact of implementing a pharmaceutical service in consultations with patients with rheumatoid arthritis

Abstract

Introduction

Rheumatoid arthritis (RA) is an autoimmune, chronic disease with significant morbidity, often hindered by access barriers to therapy.

Objective

To assess the effect of a pharmaceutical service in an outpatient rheumatology unit that dispensed medications at the end of the consultation.

Material and methods

An observational-analytical, retrospective study tracking a cohort of RA patients (before and after the introduction of the pharmacy service). Bivariate analysis was conducted using the Chi-square test, and multivariate analysis using a regression model with the variables disease remission (DAS28 (ESR) < 2.6) and moderate-to-high RA activity (DAS28 (ESR) > 3.2).

Results

A total of 544 patients were included, of which 435 (80.0%) were female. Remission was observed in 266 (48.9%) patients before and 384 (70.6%) after implementation of the pharmaceutical service. Factors associated with RA remission included biological therapy (HR .37 95% CI .25–.56), corticosteroid therapy (HR .31 95% CI .21–.44), leflunomide (HR .55 95% CI .42–.72), sulfasalazine (HR .60 95% CI .42–.86), and having access to the pharmaceutical service (HR 2.93 95% CI 2.23–3.85).

Conclusions

Implementing a pharmaceutical service that dispenses medications for rheumatoid arthritis immediately after consultation was associated with disease remission.