Drug persistence in patients with rheumatic and musculoskeletal diseases during a major economic crisis: results from a nationwide cross-sectional online survey
Abstract To evaluate the drug persistence in patients with rheumatic and musculoskeletal diseases (RMDs) during the current economic crisis in Lebanon and to estimate predictors of persistence. A nationwide multicentric cross-sectional study using an online questionnaire was conducted in Lebanon with patients with chronic inflammatory rheumatic diseases (CIRDs) and non-inflammatory RMDs controls between July and October 2022. Disease-modifying antirheumatic drugs (DMARDs) were categorized as conventional synthetic (cs), biological (b), subcutaneous (SC) or intravenous (IV), and targeted synthetic (ts). Persistence was defined as “number of tablets or injections taken during the past month versus prescribed”. The percentage of patients who discontinued or changed treatment due to cost or non-availability was reported. Factors associated with persistence were identified using multivariable linear regression. The study included 317 patients with RMDs (286 CIRDs); mean age 49.5 years, 68% females, 58% reporting currently low economic level. Persistence at one month was low for tsDMARDs (36%) and bDMARDs (SC55%, IV63%), and acceptable for csDMARDs (88%). A persistence ≥80% was found in 23.3% of patients on tsDMARDs, 42.9% on SC bDMARDs, 45.0% on IV bDMARDs, and 74.7% on csDMARDs. During the past 6 months, 55.8% of CIRD patients discontinued or changed treatment due to non-availability (45.3%) or cost (21.2%). Persistence was positively associated with finding alternative sources such as buying abroad (36%), depending on friends or families abroad (20%), charities (10%), and negatively associated with unemployment and low financial status. Persistence was significantly compromised for essential antirheumatic drugs and was mostly driven by treatment unavailability and cost..
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:44 |
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| Enthalten in: |
Rheumatology international - 44(2024), 4 vom: 31. Jan., Seite 725-736 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Asmar, Serena [VerfasserIn] |
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| Links: |
Volltext [lizenzpflichtig] |
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| Themen: |
Access to health care |
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| Anmerkungen: |
© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. |
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| doi: |
10.1007/s00296-023-05526-9 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 520 | |a Abstract To evaluate the drug persistence in patients with rheumatic and musculoskeletal diseases (RMDs) during the current economic crisis in Lebanon and to estimate predictors of persistence. A nationwide multicentric cross-sectional study using an online questionnaire was conducted in Lebanon with patients with chronic inflammatory rheumatic diseases (CIRDs) and non-inflammatory RMDs controls between July and October 2022. Disease-modifying antirheumatic drugs (DMARDs) were categorized as conventional synthetic (cs), biological (b), subcutaneous (SC) or intravenous (IV), and targeted synthetic (ts). Persistence was defined as “number of tablets or injections taken during the past month versus prescribed”. The percentage of patients who discontinued or changed treatment due to cost or non-availability was reported. Factors associated with persistence were identified using multivariable linear regression. The study included 317 patients with RMDs (286 CIRDs); mean age 49.5 years, 68% females, 58% reporting currently low economic level. Persistence at one month was low for tsDMARDs (36%) and bDMARDs (SC55%, IV63%), and acceptable for csDMARDs (88%). A persistence ≥80% was found in 23.3% of patients on tsDMARDs, 42.9% on SC bDMARDs, 45.0% on IV bDMARDs, and 74.7% on csDMARDs. During the past 6 months, 55.8% of CIRD patients discontinued or changed treatment due to non-availability (45.3%) or cost (21.2%). Persistence was positively associated with finding alternative sources such as buying abroad (36%), depending on friends or families abroad (20%), charities (10%), and negatively associated with unemployment and low financial status. Persistence was significantly compromised for essential antirheumatic drugs and was mostly driven by treatment unavailability and cost. | ||
| 650 | 4 | |a Disease-modifying antirheumatic drugs |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Lebanon |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Economic instability |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Access to health care |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Access to medications |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Medication adherence |7 (dpeaa)DE-He213 | |
| 650 | 4 | |a Surveys and questionnaires |7 (dpeaa)DE-He213 | |
| 700 | 1 | |a Messaykeh, Jamil |4 aut | |
| 700 | 1 | |a Hilal, Nadeen |4 aut | |
| 700 | 1 | |a Rida, Mohamad Ali |0 (orcid)0000-0001-9858-2923 |4 aut | |
| 700 | 1 | |a Mroue, Kamel |4 aut | |
| 700 | 1 | |a Aouad, Krystel |0 (orcid)0000-0001-8708-9324 |4 aut | |
| 700 | 1 | |a Minkara, Fouad |4 aut | |
| 700 | 1 | |a Hajjar, Arlette |4 aut | |
| 700 | 1 | |a Ziade, Nelly |0 (orcid)0000-0002-4479-7678 |4 aut | |
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