One quarter of patients with chronic inflammatory rheumatic diseases stop taking their medicines. To find out why, researchers at University Grenoble-Alpes in Grenoble, France conducted an online survey of patients taking biologics for chronic inflammatory conditions including rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. The study results were published earlier this year in the Journal of Rheumatology.

Most of the patients surveyed reported side effects that had disrupted their daily activities. Although patients who self-discontinued their biologics sometimes gave side effects as the reason why, they were no more likely to have side effects than patients who discontinued for other reasons.

Another reason for discontinuing was a low level of pain: 63.9% rated their pain four or below on a 10-point scale, compared to 52.7% of patients who stayed on their medication. Additional reasons for discontinuing their medication included “I felt better,” (38.4%), side effects (28.6%) and the “treatment didn’t work” (13.4%).

Self-administration is another factor, Benoît Allenet, PharmD., Ph.D., a professor of clinical pharmacy told Rheumatology Network. “I think some of the treatment failures you have are people who don’t take the drug in the correct way,” he said. Other factors included having tried more than one biologic, negative beliefs about treatment and lack of perceived medical and social support.

The researchers concluded that health care workers need to educate patients about the efficacy and side effects of biologics, and that pharmacists could play a key role, particularly in allaying patient fears that these biologic drugs will cause cancer or some other serious side effects. Patients may feel more comfortable discussing their concerns with a pharmacist than their doctor, Allenet said.

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