[Implementation, of multidisciplinary consultations for patients with inflammatory arthritis and treated with subcutaneous biologic DMARDs: Assessment at one year and outlook]

Ann Pharm Fr. 2023 Mar;81(2):370-379. doi: 10.1016/j.pharma.2022.08.011. Epub 2022 Aug 29.
[Article in French]

Abstract

Introduction: Biologics (bDMARDs) have revolutionized the prognosis of patients with inflammatory arthritis, but are not without serious side effects. The patient must be able to identify them, acquire self-care abilities or skills and adhere to their treatment. Multidisciplinary consultations, including a pharmaceutical consultation could improve the care of these patients. The pharmaceutical presence make it easier to switch to a biosimilar with etended patient support thanks to the community-hospital network. The return on investment is possible thanks to the more frequent use of biosimilars and the pricing of this type of consultation by the "Forfait de Prestation Intermédiaire".

Methodology: Eligible patients are patients with rheumatoid arthritis or spondyloarthritis, treated with subcutaneous bDMARDs. The criteria assessed were patient's knowledge of their biotherapy using the Biosecure score, their medication adherence using the CQR-5, the total of switch to biosimilars perform and the financial statement of the consultations. An assessment of the actions deployed for the community-hospital network.

Results: Two hundred and ninety-five patients (47.4%) benefited multidisciplinary consultation. The mean score of the Biosecure score was 69.6/100 (moderate knowledge) and 261 patients (88.5%) were highly adherent. 57 patients (73%) accepted the switch to biosimilar. 197 pharmacy were contacted, all of witch for patients who receive the switch. Overall patient's satisfaction was 26.9/28.

Conclusion: Multidisciplinary consultations with involvement of the pharmacist should optimized patient care and the management of outpatients treated with bDMARDs. Patients have already expressed their satisfaction with this course of care and the return on investment is positive.

Keywords: Adherence; Adhésion; Biotherapy; Biothérapie; Chronic inflammatory rheumatism; Community-hospital network; Connaissances; Consultation pharmaceutique; Knowledge; Lien ville-hôpital; Rhumatismes inflammatoires chroniques.

Publication types

  • English Abstract

MeSH terms

  • Antirheumatic Agents* / therapeutic use
  • Arthritis, Rheumatoid* / drug therapy
  • Biosimilar Pharmaceuticals*
  • Humans
  • Pharmaceutical Preparations
  • Referral and Consultation

Substances

  • Biosimilar Pharmaceuticals
  • Antirheumatic Agents
  • Pharmaceutical Preparations