title: Factors associated with knowledge and safety skills of arthritis patients receiving biologics: A survey of 677 patients.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Lorraine université, université Paris Descartes, EA4360 Apemac, 54395 Nancy, France; Inserm, CIC-EC 1433, CHU de Nancy, 54511 Vandſuvre-lès-Nancy, France; Department of rheumatology, CHU de Nancy, rue du Morvan, 54511 Vandſuvre-lès-Nancy, France. Electronic address: ac.rat@chu-nancy.fr.
authors.forename: Anne-Christine
authors.initials: AC
authors.lastname: Rat
authors.affiliation: Université Pierre-et-Marie-Curie (UPMC)-Paris 6, GRC-UMPC 08 (EEMOIS), 75006 Paris, France; Department of Rheumatology, Pitié-Salpêtrière Hospital, AP⿿HP, 75013 Paris, France.
authors.forename: Bruno
authors.initials: B
authors.lastname: Fautrel
authors.affiliation: Rheumatology B Department, Cochin Hospital, 75014 Paris, France.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Flipon
authors.affiliation: Université Pierre-et-Marie-Curie (UPMC)-Paris 6, GRC-UMPC 08 (EEMOIS), 75006 Paris, France; Department of Rheumatology, Pitié-Salpêtrière Hospital, AP⿿HP, 75013 Paris, France.
authors.forename: Laure
authors.initials: L
authors.lastname: Gossec
authors.affiliation: Rheumatology department, Institut Calot, 62600 Berck, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Marguerie
authors.affiliation: Cabinet de rhumatologie, 78200 Mantes-la-Jolie, France.
authors.forename: Henri
authors.initials: H
authors.lastname: Nataf
authors.affiliation: Rheumatology department, Saint-ÿtienne university hospital, 42055 Saint-ÿtienne, France.
authors.forename: Béatrice
authors.initials: B
authors.lastname: Pallot-Prades
authors.affiliation: Rheumatology Department, Saint-Antoine Hospital, AP⿿HP, 75012 Paris, France.
authors.forename: Rose-Marie
authors.initials: RM
authors.lastname: Poilvert
authors.affiliation: Hôpital Louis-Pasteur, 28000 Chartres, France.
authors.forename: Valérie
authors.initials: V
authors.lastname: Royant
authors.affiliation: Victor-Jousselin Hospital, 28100 Dreux, France.
authors.forename: Fatiha
authors.initials: F
authors.lastname: Sadji
authors.affiliation: Rheumatology Department, Strasbourg University Hospital, 67100 Strasbourg, France.
authors.forename: Christelle
authors.initials: C
authors.lastname: Sordet
authors.affiliation: Department of internal medicine, Laon hospital, 02408 Laon, France.
authors.forename: Corinne
authors.initials: C
authors.lastname: Thevenot
authors.affiliation: Rheumatology Department, Saint-Antoine Hospital, AP⿿HP, 75012 Paris, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Beauvais
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy*; D001688:Biological Products / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety
chemical_list: D018501:Antirheumatic Agents; D001688:Biological Products
keywords: Biologics; Coping; Inflammatory arthritis; Intravenous injections; Knowledge; Safety; Subcutaneous injection; Therapeutic education