Adherence, Fears, and Beliefs about Biologic Drugs in Rheumatoid Arthritis Patients: A North African Pilot Study.

Purpose: To investigate the impact of beliefs in adherence to biologic drugs among patients with rheumatoid arthritis (RA).

Methods: This was a cross-sectional study, including RA patients who were on biologic disease-modifying antirheumatic drugs (bDMARDs). Therapeutic adherence was evaluated arbitrarily using a self-reported method by asking them the following question: "Do you regul arly take your biologic drug as prescribed by your doctor?". The Beliefs about Medicines Questionnaire (BMQ) was used to evaluate medication beliefs [general overuse, general harm, specific necessity, specific concerns].

Results: Seventy-five RA patients were included (80.0% females, 33.3% illiterate, and 68.0% unemployed, mean age: 57±9 years, mean disease activity score: 3.94±1.32). Adherence to the current biologic drug was reported by 71 patients (94.7%). The means ± standard deviation scores for general overuse, general harm, specific necessity, and specific concerns were 14.0±2.4, 10.8±4.4, 20.6±5.7, and 10.3±3.3, respectively. Compared to the adherent group (n=71), the non-adherent group (n=4) had a lower specific necessity score (21.0±5.4 vs. 13.5±7.5, respectively, p=0.009), a higher specific concern score (10.1±3.13 vs. 15.0±2.8, respectively, p=0.036), and similar scores for general overuse and general harm (10.0±2.3 vs. 9.5±1.9, p=0600; 13.3±4.4 vs. 11.5±4.1, p=0.400, respectively). In logistic regression, specific necessity and specific concerns scores were significantly associated with adherence (Odds-ratio (OR)= 0.855, 95% confidence interval (CI) [0.726-1.006], and 1.438, 95% CI [1.004-1.980], respectively).

Conclusion: Our study showed that RA patients have strong beliefs about the necessity to take biologic drugs which significantly influence the adherent behaviour therapy.