Assessment of adherence to drug and non-drug treatments and its changes under the influence of an education program in patients with rheumatoid arthritis

Abstract

Objective: to assess awareness of drug and non-drug treatments for rheumatoid arthritis (RA) and compliance in patients before and after their participation in an education program, as well as the survival of the knowledge and the need for retraining. Subjects and methods. The study included 43 patients with RA: 23 study group patients were trained according to an education program (Rheumatoid Arthritis Health School), 20 patients formed a control group. The education program consisted of 4 daily 90-min studies. Adherence to drug and non-drug treatments was assessed at baseline and at 3 and 6 months. Results. In the study group, the basic therapy remained stably high (about 100%) within 6 months. At 3 months after studies, nonsteroidal anti-inflammatory drugs could be discontinued in 23.8% (p < 0.05). After 6 months, the proportion of patients using laser therapy increased by 57.1% (p < 0.01) and accounted for 47.8%; the use of electric and ultrasound treatments showed a 55.6% increase (p < 0.01) and was 60.9%. The number of patients who were compliant to the procedures for shaping a correct functional stereotype increased by 14 and 10 times following 3 and 6 months (60.9% and 43.5%, respectively; p < 0.01). After 3 months, there was a rise in the number of patients using hand ortheses by 75.0% (30.4%; p < 0.01); knee ortheses by 50.0% (39.1%; p < 0.01); individual inner soles by 71.4% (52.2%; p < 0.01); and walking sticks and crutches by 60.0% (34.8%; p < 0.01). Following 6 months, the positive changes remained only after the relative use of inner soles (60.9%) and support means (34.8%; p < 0.05). The number of patients who regularly did physical activity increased by 5.3 (69.6%; р < 0.01) and 3.7 (47.8%; p < 0.01) times at 3 and 6 months, respectively. The trend in the control group was less pronounced, determining statistically significant differences between the groups in most indicators (р < 0.05). Conclusion. The education program retains high compliance to the basic therapy, reduces needs for symptomatic drugs, and enhances adherence to physiotherapy, methods for shaping a correct motor stereotype, orthesis wearing, and regular physical activity. The maximum positive result of the Rheumatoid Arthritis Health School was achieved after 3 months; this effect slightly diminished at 6 months. This necessitates retraining in the following 3-6 months.

Keywords

• rheumatoid arthritis
• education program
• patient education_