[Effectiveness on adherence to biological drugs and experience of a pharmaceutical intervention based on CMO model in patients with rheumatic disease (AdhER-2 study)].

Abstract

Background: We aimed to assess the effectiveness on adherence to treatment with biologic disease modifying anti-rheumatic drugs (b-DMARD) and experience with providers of healthcare of a CMO pharmaceutical intervention care model in subjects with rheu-matoid arthritis, psoriatic arthritis, and ankylosing spondylitis stratified according to their needs.

Method: Prospective, single-centre randomized controlled study. The study period was eleven months. Non-compliant patients with rheumatoid arthritis, psoriatic arthritis, and ankylosing spondy-litis treated with b-DMARD were included. Patients were randomized to a control (CG) or intervention group (IG) who received regular or the CMO pharmaceutical intervention model treatment, respec-tively. Baseline and final adherence were determined using medication possession ratio, the Compliance Questionnaire on Rheu-matology, and Morisky Medication Adherence Scale. To assess baseline and final patient experience with providers of healthcare we applied the Chronic Patient Experience Assessment Instrument (IEXPAC).

Results: For the IG, one patient (5.6%) was categorized as priority 1, nine (50.0%) as priority 2, and eight (44.4%) as priority 3. Ninety pharmaceutical interventions were carried out (5.1±1.8 interventions / patient). At the end of the study, the IG showed higher fre-quency of patients who adhered to the pharmaceutical intervention (77.8 vs 18.8%; p=0.002) and higher mean IEXPAC score (7.6±1.3 vs 5.8±1.1; p <0.001) in comparison to the CG. Conclusion The CMO pharmaceutical intervention model significantly improves patient adherence to b-DMARD and their experience with the providers of healthcare.