title: Why Do Patients with Chronic Inflammatory Rheumatic Diseases Discontinue Their Biologics? An Assessment of Patients' Adherence Using a Self-report Questionnaire.
abstract: OBJECTIVE
  Concerns have been raised about nonadherence behavior among patients with chronic inflammatory rheumatic diseases (CIRD) receiving biologics. This nonadherence may be caused by various factors. The main objective was to explain why patients discontinue their biologics of their own accord.
  
  
  METHODS
  A quantitative and descriptive study was performed using a self-report questionnaire that was sent through the Internet to members of different patient associations. Sociodemographic data, medical and therapeutic history, management of biologic administration, previous experiences, and patients' beliefs and perceptions about treatment efficacy and side effects were studied to explain self-discontinuation (SD).
  
  
  RESULTS
  A total of 581 patients answered the questionnaire between June 16, 2012, and July 4, 2012, including patients with ankylosing spondylitis (351/581, 60.4%), rheumatoid arthritis (196/581, 33.7%), psoriatic arthritis (30/581, 5.2%), and other CIRD (4/581, 0.7%). More than 1000 different biologics were described by the 581 patients, with a median of 2 lines per patient. Eighty-six patients discontinued their biologics of their own accord (14.8%). In a multivariate analysis, factors that were significantly related to SD were low level of pain, more than 1 line of biologics tried, self-administration of biologics, negative beliefs about the treatment, and a lack of medical and social support.
  
  
  CONCLUSIONS
  Five predictive factors of this SD were identified, which should be assessed in routine with patients with CIRD receiving biologic treatment: pain, treatment history, self-administration of injections, negative beliefs about treatment, and a lack of perceived medical and social support.
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Betegnie
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Aurélie
authors.initials: A
authors.lastname: Gauchet
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Audrey
authors.initials: A
authors.lastname: Lehmann
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Laurent
authors.initials: L
authors.lastname: Grange
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Matthieu
authors.initials: M
authors.lastname: Roustit
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Magalie
authors.initials: M
authors.lastname: Baudrant
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas.
authors.forename: Pierrick
authors.initials: P
authors.lastname: Bedouch
authors.affiliation: From the Pharmacy Department, University Hospital; Interuniversity Laboratory of Psychology: Personality, Cognition, Social Change (LIP/PC2S), University Grenoble-Alpes; Rheumatology Clinic, and Clinical Research Center, Grenoble University Hospital; University Grenoble-Alpes/Centre National de la Recherche Scientifique (CNRS)/Techniques de l'Ingénierie Médicale et de la Complexité - Informatique, Mathématiques et Applications, Grenoble Unité Mixte de Recherche CNRS #5525 (TIMC-IMAG UMR 5525)/Themas, Grenoble, France.A.L. Betegnie, PharmD, Pharmacy Department, University Hospital; A. Gauchet, MS, PhD, LIP/PC2S, University Grenoble-Alpes; A. Lehmann, PharmD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; L. Grange, MD, PhD, Rheumatology Clinic, Grenoble University Hospital; M. Roustit, PharmD, PhD, Clinical Research Center, Grenoble University Hospital; M. Baudrant, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; P. Bedouch, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas; B. Allenet, PharmD, PhD, Pharmacy Department, University Hospital, and the University Grenoble-Alpes/CNRS/TIMC-IMAG UMR 5525/Themas. BAllenet@chu-grenoble.fr.
authors.forename: Benoît
authors.initials: B
authors.lastname: Allenet
mesh_terms: D000328:Adult; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D008875:Middle Aged; D057566:Self Report; D012944:Social Support; D013167:Spondylitis, Ankylosing / Q000188:drug therapy*; D011795:Surveys and Questionnaires
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products
keywords: ADHERENCE; BELIEFS; BIOLOGICS; DISCONTINUATION; PATIENT EDUCATION; RHEUMATIC DISEASE