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Adherence to therapy in people with rheumatic and musculoskeletal diseases in Italy and the role of the digital health: results of an expert Delphi consensus survey

1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13

 

  1. Academic Rheumatology Centre, AO Mauriziano Torino, and Dipartimento Scienze Cliniche e Biologiche, Università degli Studi di Torino, Italy. annamaria.iagnocco1@gmail.com
  2. Department of Precision Medicine, University of Campania L. Vanvitelli, Naples, Italy.
  3. Division of Rheumatology, Department of Internal Clinical Sciences, Anaesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Italy.
  4. Rheumatology Department of Lucania, San Carlo Hospital, Potenza, Italy.
  5. Division of Rheumatology, Multispecialist Medical Department, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy.
  6. Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Italy.
  7. Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Florence, Italy.
  8. Rheumatology Unit, DiMePRe-J, University of Bari, Italy.
  9. Department of Rheumatology, University of Pisa, Italy.
  10. Rheumatology Unit, Department of Clinical and Molecular Sciences, Polytechnic University of Marche, Ancona, Italy.
  11. Rheumatology Unit, San Camillo-Forlanini Hospital, Rome, Italy.
  12. Hippocrates Sintech, Genova, Italy.
  13. Division of Clinical Rheumatology, ASST Gaetano Pini-CTO Institute, Milan, and Department of Clinical Sciences and Community Health, University of Milan, Italy.

CER16732
2023 Vol.41, N°9
PI 1917, PF 1925
Review

purchase article

PMID: 37382465 [PubMed]

Received: 04/04/2023
Accepted : 29/05/2023
In Press: 28/06/2023
Published: 17/08/2023

Abstract

OBJECTIVES:
To present the results of a Delphi consensus survey among Italian rheumatologists on adherence to therapy in people with rheumatic and musculoskeletal diseases (RMDs) in Italy and the role of digital health.
METHODS:
A taskforce of 12 rheumatologists comprehensively discussed the applicability of the 2020 EULAR Points to Consider (PtCs) for Italian rheumatology practice and formulated 44 new country-specific statements. Through an on-line survey, the panellists voted on their level of agreement with the statements using a 10-point Likert scale (0: no agreement; 10: total agreement). A combination of two distinct criteria, a mean agreement level ≥8 and a percentage of at least 75% of responses with a value ≥8, was deemed acceptable.
RESULTS:
The consensus threshold was reached for 43 of the 44 country-specific statements. The following were acknowledged among the barriers to applicability of the recommendations: visit time too short; lack of resources; lack of a clear operational flow-chart; lack of communication skills and poor knowledge of techniques to improve patient adherence by healthcare professionals (HCPs).
CONCLUSIONS:
This consensus initiative helps contribute to more widespread implementation of EULAR PtCs in Italian rheumatology practice. Optimisation of visit time, greater availability of resources, specific training, use of standardised and validated protocols, and active involvement of patients represent the main goals. Digital health can provide valuable support for the application of PtCs and, more generally, in improving adherence. A collaborative effort between HCPs, patients and their associations, scientific societies, and policymakers is strongly advocated to overcome some of the barriers.

DOI: https://doi.org/10.55563/clinexprheumatol/uip1u1

Rheumatology Article