RESUMO
Introduction/Objective: The patient activation measure (PAM) is considered a reliable tool for measuring patient activation. This study aimed to systematically review the scientific literature regarding the use of PAM -13 in rheumatology patients and to compare PAM scores in patients with rheumatoid arthritis (RA) following two different practices at a single institution with previously published studies. Methods: The study consisted of a systematic review of articles reporting the PAM-13 in patients with RA, followed by a cross-sectional study evaluating PAM scores between standard rheumatology clinics and specialized rheumatology clinics (SRCs). The correlation between PAM levels and other variables, such as demographics, disease characteristics, and treatment, was assessed. Results: Nineteen studies, published between 2012 and 2022, met the inclusion criteria. The studies in this review had inconsistent results and quality, with patient activation in RA ranging from 29 to 76. A total of 197 patients with confirmed RA diagnoses were interviewed (response rate, 88%). Most were female (n=173, 88%) and older than 40 years (n=150, 76%). The average patient activation score was 64.9 (standard deviation, 15.7). Most participants had level 3 and 4 patient activation measures (n=71 [36%] and n=72[37%], respectively). Patients who were attending SRCs also had borderline higher PAM levels. Patients with high PAM scores tended to be older, have active disease, and were taking corticosteroids. Conclusion: Adequate activation of patients was observed from our center, which was higher than that reported in most published literature. The PAM of patients with RA was variable according to the systematic review. Longitudinal interventional studies should be considered to improve activation in patients with low scores.
RESUMO
Background: Few Saudi studies have examined adverse drug reactions (ADRs) in patients with rheumatoid arthritis (RA) receiving intravenous (IV) originator biologics. Therefore, this study aimed to evaluate the prevalence, types, and predictors of ADRs following long-term IV originator biologic use in patients with RA. Patients and methods: This retrospective, single-center study included adult patients with RA who received IV originator biologics between 2015 and 2020. Medical records were reviewed and data regarding ADRs were collected and evaluated for causality using the Naranjo scale. Binary logistic regression analysis was performed to identify the odds for and factors associated with developing ADRs for each biologic. Results: A total of 129 patients (87.6% women) with a mean (standard deviation) age of 54 (13) years were included in this study. A total of 1963 doses of tocilizumab (38.76%), rituximab (38.76%), abatacept (13.95%), and infliximab (8.53%), were administered during the study period. ADRs with a Naranjo score ≥ 1 were experienced by 103 (78%) patients, with an average of 2.2 events per patient. Infection (26.6%) and skin and mucous membrane disorders (14.18%) were the most commonly reported ADRs. Abatacept was associated with a significantly higher risk of multiple ADRs than the other biologics (adjusted odds ratio: 3.145, 95% confidence interval 1.004-9.854, p = 0.049). Conclusion: There was a high prevalence of ADRs among patients with RA receiving biologics. Abatacept was associated with a greater risk of multiple ADRs than other biologics. Infection was the most common ADR. Future multicenter longitudinal studies are warranted.
