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Background: Treatment adherence in rheumatic patients is often a challenge and has a negative impact on the cost-effectiveness of therapies. Fibromyalgia (FM) is one of the rheumatic diseases most strongly associated with poor treatment adherence. Screening rheumatic patients for associated FM or FM spectrum symptoms can help identify those who are more likely to be medication non-adherent and could benefit from tighter control or personalized therapeutic strategies. Objectives: To investigate treatment adherence in a cohort of patients with a pool of rheumatic diseases in relation to the prevalence of FM or FM–related symptoms and to identify risk factors associated with poor medication compliance. Methods: In this cross-sectional cohort study outpatients with a diagnosed rheumatic disease from the Rheumatology Unit of the University Hospital "G. Martino" in Messina were consecutively enrolled by face-to-face or telephone interview. Specifically, patients were screened for primary or associated FM based on the ACR 2016 criteria, and assessed for FM disease activity, quality of life, physical and psychological symptoms using the FIQR, FAS, BDI and SF-36 questionnaires. Treatment adherence was measured using the MMAS-8 questionnaire. Demographic and clinical data were also collected. Results: We consecutively enrolled a total of 100 patients whose demographic and clinical characteristics are listed in Table 1. Of them, 54 had FM, which was primary in 28 cases. Other rheumatic diseases included osteoarthritis and inflammatory conditions such as arthritis and connective tissue diseases. Overall, adherence to pharmacologic treatment (immunosuppressants, steroids, analgesics, NSAIDs, muscle relaxants, antiepileptics, antidepressants and nutritional supplements) was good, with MMAS-8 scores = 8 in 69% of cases. When categorizing patients according to the 2016 ACR FM criteria, we found a significant difference in MMAS-8 scores as well as FIQR, FAS, SSS, WPI, SF-36, and BDI scores (unpaired two-sample t-test, Table 2). Fibromyalgia and worse WPI, SSS, FAS, FIQR and BDI scores were associated with risk of low medication adherence (unpaired two-sample t-test and Fisher's exact test, Table 3). Conclusion: The results of this study show a high prevalence of FM and FM-related symptoms in rheumatic patients, which may affect medication adherence. Questionnaires can help to identify individuals at higher risk of discontinuing therapy. REFERENCES: NIL. Acknowledgements: NIL. Disclosure of Interests: None declared.
Rapisarda et al. (Sat,) studied this question.
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