Use of immunosuppressive antirheumatic medication and medication adherence
| March 2020 | Answering options | June 2020 | ||
| Question | Answer, n (%) | Answer, n (%) | Question | |
| Did you on start of the COVID-19 lock-down use immunosuppressing antirheumatic medication? | 10 089 (79) | Yes | 9685 (76) | Do you currently use immunosuppressing antirheumatic medication? |
| 2226 (17) | No | 2184 (17) | ||
| 427 (3) | Do not know | 519 (4) | ||
| 47 (–) | Missing | 401 (–) | ||
| If yes, did you change the dose* | 1029 (10) | Yes | 657 (7) | If yes, do you currently use another dose than prior to the COVID-10 pandemic* |
| 8997 (89) | No | 8953 (92) | ||
| 60 (1) | Do not know | 67 (1) | ||
| 3 (–) | Missing | 9 (–) | ||
| If yes to change, which medication(s) was affected? >1 medication per patient allowed † | 546 (54) | csDMARD | 374 (63) | If yes to change, which medication(s) are affected?>1 medication per patient allowed † |
| 45 (4) | Prednisolone | 57 (10) | ||
| 417 (41) | bDMARD | 160 (27) | ||
| 21 (–) | Missing/other | 66 (–) | ||
| Change of bDMARD n=417 patients (4%)* | Change of bDMARD n=160 patients (2%)* | |||
| If yes to change, how did you change the dose§? | 18 (4) | Dose increase | 47 (29) | If yes to change, how did you change the dose§? |
| 39 (9) | Dose reduction | 27 (17) | ||
| 262 (63) | Paused medication | 17 (11) | ||
| 70 (17) | Stopped medication | 13 (8) | ||
| 38 (–) | Missing | 64 (–) | ||
| If yes to change, who recommended the change?§ | 258 (62) | Own initiative | 28 (18) | If yes to change, who recommended the change?§ |
| 11 (3) | General practitioner | 0 (0) | ||
| 102 (24) | Rheumatology clinic | 88 (55) | ||
| 20 (5) | Other | 5 (3) | ||
| 2 (0) | Do not know | 1 (1) | ||
| 34 (–) | Missing | 46 (–) | ||
| If yes to change, what was the reason(s)? | 28 (7) | My disease changed | 57 (36) | If yes to dose-change, what is the reason(s)? |
| 4 (1) | No assess to medication | 2 (1) | ||
| 211 (51) | Fear of COVID-19‡ | 20 (13) | ||
| 38 (9) | Worry about side-effects | 8 (5) | ||
| 10 (2) | No need to take medication | 5 (3) | ||
| 2 (0) | Avoid blood sampling | 0 (0) | ||
| 95 (23) | Other | 23 (14) | ||
| 2 (0) | Do not know | 2 (1) | ||
| 37 (–) | Missing | 51 (–) | ||
| Change of csDMARD including prednisolone, n=583 patients (6%) | Change of csDMARD including prednisolone, n=419 patients (4%) | |||
| If yes to change, how did you change the dose§? | 92 (16) | Dose increase | 166 (40) | If yes to change, how did you change the dose§? |
| 143 (25) | Dose reduction | 153 (37) | ||
| 228 (39) | Paused medication | 19 (5) | ||
| 108 (19) | Stopped medication | 30 (7) | ||
| 43 (–) | Missing | 84 (–) | ||
| If yes to change, who recommended the change§? | 294 (50) | Own initiative | 91 (22) | If yes to change, who recommended the change?§ |
| 20 (3) | General practitioner | 6 (1) | ||
| 230 (39) | Rheumatology clinic | 261 (62) | ||
| 23 (4) | Other | 19 (5) | ||
| 2 (0) | Do not know | 1 (0) | ||
| 45 (–) | Missing | 74 (–) | ||
| If yes to change, what was the reason(s)§? | 97 (17) | My disease changed | 168 (40) | If yes to dose-change, what is the reason(s)? |
| 8 (1) | No assess to medication | 15 (4) | ||
| 231 (40) | Fear of COVID-19‡ | 36 (9) | ||
| 68 (12) | Worry about side-effects | 52 (12) | ||
| 21 (4) | No need to take medication | 16 (4) | ||
| 6 (1) | Avoid blood sampling | 2 (0) | ||
| 129 (22) | Other | 75 (18) | ||
| 6 (1) | Do not know | 5 (1) | ||
| 48 (–) | Missing | 83 (–) | ||
N=12 789.
*Percentage of medication users.
†Percentage of medication changes.
‡Number of patients changing at least one medication due to fear of COVID-19: March: 415/10 089 (4.1%), June: 54/9685 (0.6%).
§More than 1 medication/answer allowed per patient.
bDMARD, biological disease-modifying antirheumatic agent; csDMARD, conventional synthetic disease-modifying antirheumatic drug.