Factors associated with knowledge and safety skills of arthritis patients receiving biologics: A survey of 677 patients - 27/05/16

Doi : 10.1016/j.jbspin.2016.02.026

Anne-Christine Rat ^a,^b,^c,^⁎ , Bruno Fautrel ^d,^e, Elisabeth Flipon ^f, Laure Gossec ^d,^e, Laurent Marguerie ^g, Henri Nataf ^h, Béatrice Pallot-Prades ⁱ, Rose-Marie Poilvert ^j, Valérie Royant ^k, Fatiha Sadji ^l, Christelle Sordet ^m, Corinne Thevenot ⁿ, Catherine Beauvais ^j
French Society of Rheumatology Patient Education section
^a Lorraine université, université Paris Descartes, EA4360 Apemac, 54395 Nancy, France
^b Inserm, CIC-EC 1433, CHU de Nancy, 54511 Vandœuvre-lès-Nancy, France
^c Department of rheumatology, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France
^d Université Pierre-et-Marie-Curie (UPMC)-Paris 6, GRC-UMPC 08 (EEMOIS), 75006 Paris, France
^e Department of Rheumatology, Pitié-Salpêtrière Hospital, AP–HP, 75013 Paris, France
^f Rheumatology B Department, Cochin Hospital, 75014 Paris, France
^g Rheumatology department, Institut Calot, 62600 Berck, France
^h Cabinet de rhumatologie, 78200 Mantes-la-Jolie, France
ⁱ Rheumatology department, Saint-Étienne university hospital, 42055 Saint-Étienne, France
^j Rheumatology Department, Saint-Antoine Hospital, AP–HP, 75012 Paris, France
^k Hôpital Louis-Pasteur, 28000 Chartres, France
^l Victor-Jousselin Hospital, 28100 Dreux, France
^m Rheumatology Department, Strasbourg University Hospital, 67100 Strasbourg, France
ⁿ Department of internal medicine, Laon hospital, 02408 Laon, France

^⁎Corresponding author. Department of rheumatology, CHU de Nancy, rue du Morvan, 54511 Vandœuvre-lès-Nancy, France.

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Abstract

Objective

We aimed to determine patient and rheumatologist factors associated with the safety skills of patients receiving bDMARDs for inflammatory arthritis.

Methods

Data were obtained from a descriptive observational cross-sectional nationwide survey performed in 2011 in France. Community- and hospital-based rheumatologists were selected at random. The BioSecure questionnaire was used to collect information on patient safety skills.

Results

Of the 677 patients included (mean age 53±13years old; 452 (67%) women, 411 (61%) had RA; 421 (64%) received subcutaneous bDMARDs). Patients had received information about their treatments from their physician 610 (90%), a nurse 207 (31%), by a written booklet 398 (59%), and/or during therapeutic patient education (TPE) sessions 99 (15%). The median BioSecure total score was 72/100 (IQR 60-82). In total, 99 (16.4%) patients had a low skill level; 321 (53.2%) a moderate skill level and 183 (30.3%) a high skill level. On multivariate regression analysis, as compared with high safety skills, low skills were associated with living alone (OR 2.8 [95% CI 1.3–6.0]), low educational level (OR 4.3 [2.1–8.9]), living in a large city (OR 3.1 [1.2–8.2]), being unemployed (OR 3.3 [1.6–6.7]) and not receiving written information, participating in TPE sessions or consulting a nurse (OR 3.8 [1.6–8.8]). One rheumatologist-related factor was a high number of patients receiving bDMARDs in the practice.

Conclusion

We reveal factors associated with low safety skills of patients receiving bDMARDs for inflammatory arthritis, which should be addressed to improve safety skills in this population.

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Keywords : Biologics, Subcutaneous injection, Intravenous injections, Coping, Knowledge, Therapeutic education, Inflammatory arthritis, Safety