NEW YORK (Reuters Health)—Many patients with arthritis lack the knowledge to use their biologic treatments safely, researchers from France report.
“Some patients are at risk of poorly managing their biologic therapy, especially patients living alone, in a large city, patients with low education level, or (patients who are) unemployed,” Dr. Anne-Christine Rat from CHU de Nancy in Vandoeuvre-les-Nancy tells Reuters Health by email.
Because of the risks associated with biologic treatments, arthritis patients must have decision-making and safety skills for such situations as fever, dental care and planned surgery, including not injecting the biologic treatment, consulting their physician or seeking advice from other healthcare professionals.
Dr. Rat and colleagues from the French Society of Rheumatology Patient Education section used the 54-item BioSecure questionnaire to investigate factors associated with the level of knowledge and behavioral safety skills of 677 patients with inflammatory arthritis treated with biologic disease-modifying anti-rheumatic drugs (bDMARDs).
Based on BioSecure total scores, 16.4% of patients had low skill levels (more than 20 wrong items), 53.2% had moderate skill levels (nine to 20 wrong items), and 30.3% had high skill levels (fewer than nine wrong items), the researchers report in Joint Bone Spine, online May 26.
Apart from the factors mentioned by Dr. Rat, independent predictors of low skill level included not having received written information, consulted a nurse or participated in therapeutic patient education (TPE) sessions.
Independent predictors of moderate skill level (vs. high skill level) included having follow-up with a rheumatologist, having >80 patients on bDMARDs and being male (because of wrong answers about birth control).
There was no association between skill level and health-related quality of life or self-efficacy scores.
“This study emphasizes that some patients are at risk of poorly managing their biologic therapy,” the researchers conclude. “These patients should be identified and monitored to avoid major and perhaps life-threatening complications. A further step will be to prove that TPE focused on safety skills and taking into account these data is efficient.”
“Physicians should remember that we need to individualize care and adapt the messages,” Dr. Rat says. “Environmental and personal factors could affect the results of interventions, and studies should be interpreted according to these factors of variation.”
She adds that the new findings are likely generalizable to patients in other developed countries.