26rhk084 10.3205/26rhk084 urn:nbn:de:0183-26rhk0846 Meeting Abstract Bartsch Bartsch Vanessa V

Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Abteilung Rheumatologie, Nürnberg, Deutschland

author Habboub Habboub Basel B

Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Klinik für Innere Medizin 2, Nürnberg, Deutschland

author Fleck Fleck Martin M

Klinik für Innere Medizin 1, Universitätsklinikum Regensburg, Regensburg, Deutschland Asklepios Klinikum Bad Abbach, Abteilung Rheumatologie und klinische Immunologie, Bad Abbach, Deutschland

author Hueber Hueber Axel A

Friedrich-Alexander-Universität Erlangen-Nürnberg und Universitätsklinikum Erlangen, Medizinische Klinik 3 – Rheumatologie und Immunologie, Erlangen, Deutschland Klinikum Nürnberg, Paracelsus Medizinische Privatuniversität, Abteilung Rheumatologie, Nürnberg, Deutschland

author Krammer Krammer Olga Barbara OB

Asklepios Klinikum Bad Abbach, Abteilung Rheumatologie und klinische Immunologie, Bad Abbach, Deutschland

author German Medical Science GMS Publishing House

Düsseldorf

610 20260909 engl This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). M0656 084 Deutsche Gesellschaft für Rheumatologie Deutsche Gesellschaft für Orthopädische Rheumatologie Gesellschaft für Kinder- und Jugendrheumatologie 54. Kongress der Deutschen Gesellschaft für Rheumatologie und Klinische Immunologie (DGRh), 36. Jahrestagung der Gesellschaft für Kinder- und Jugendrheumatologie (GKJR), 40. Jahrestagung der Deutschen Gesellschaft für Orthopädische Rheumatologie (DGORh) Deutscher Rheumatologiekongress 2026 Epidemiologie & Versorgungsforschung Leipzig 20260909 20260912 EV.40 TextIntroduction: Medication adherence is a key determinant of treatment success in inflammatory rheumatic diseases (IRDs). While disease-modifying antirheumatic drugs (DMARDs) are highly effective, suboptimal adherence remains common in routine care. The initial medication counselling, particularly the time dedicated to counselling at treatment initiation, may play an important role in supporting adherence, yet real-world data on its impact are limited. The objective of this study is to evaluate the influence of initial medication counselling, with a particular focus on counselling duration, on adherence to DMARD therapy in patients with IRDs.Methods: DRAMA is a prospective, multicentre study including adult patients with IRDs initiating treatment with a conventional DMARD or a subcutaneous biological DMARD. Patients were recruited at two rheumatology outpatient clinics. Eligible patients were ≥18 years of age with a confirmed diagnosis of rheumatoid arthritis, psoriatic arthritis or axial spondyloarthritis. At the initial visit, rheumatologists documented the duration and characteristics of the medication counselling, and patients subsequently rated the quality of the initial counselling using structured questionnaires. The primary endpoint of the study is medication adherence at 6 months, assessed using the German version of the Medication Adherence Report Scale (MARS-D) . The scale ranges from 1-5, a MARS Score of 5 indicates full adherence. For this interim analysis, patient-reported adherence after 3 months was analysed. The study was approved by the local ethics committee (ethical vote 25-50-B) and registered in the German Clinical Trials Register (DRKS00036957).Results: Recruitment was initiated on 4th of June 2025 up to 11th of January 2026 85 patients were included in the study. The majority received counseling for Methotrexate (49.4%), Adalimumab (24.7%) or Etanercept (16.5%).Among the 85 patients, counselling quality was rated highly. Adequate time and clear information were reported by 97.7% of patients. Clear explanation of side effects was reportedby 88.2%, and 91.8% felt confident to correctly take or administer their medication. Active involvement in treatment decisions was reported by 88.2%. Overall satisfaction was high, with 96.5% fully satisfied. In an overall rating (1 to 6, 1 = best), 86.8% graded the counselling with the highest mark. Fifteen rheumatologists across different career stages were involved in medication counselling (Table 1 ).Three-month follow-up data were available for 52 patients (Table 2 ). Thirty-three patients reported complete adherence (MARS-D = 5), while 19 (36.6%) showed incomplete adherence.The duration of initial medical counselling did not differ significantly between patients with complete and incomplete adherence (complete: median = 12.7 min, Q1–Q3 = 11.1–15.7; incomplete: median = 12.5 min, Q1–Q3 = 9.64–15.0; p = 0.648). Furthermore, counseling duration showed a negligible association with adherence as measured by the MARS-D (Spearman’s ρ = 0.001). Shared decision making was documented in 90.9% and 89.4% of consultations in the complete and incomplete adherence groups, respectively.Conclusion: Initial DMARD counselling was rated highly and shared decision making was frequently documented. Nevertheless, a substantial proportion of patients did not achieve complete adherence at 3 months. No significant difference in counselling duration was observed between patients with complete and incomplete adherence in this interim analysisDisclosures: Die Autoren erklären, dass im Zusammenhang mit dieser Studie keine Interessenkonflikte bestehen. Chan AHY Horne R Hankins M Chisari C The Medication Adherence Report Scale: A measurement tool for eliciting patients' reports of nonadherence 2020 Br J Clin Pharmacol 1281-1288 Chan AHY, Horne R, Hankins M, Chisari C. The Medication Adherence Report Scale: A measurement tool for eliciting patients' reports of nonadherence. Br J Clin Pharmacol. 2020;86(7):1281-1288. DOI: 10.1111/bcp.14193 http://dx.doi.org/10.1111/bcp.14193 11

Table 1: Baseline characteristics of participating rheumatologists

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Table 2: Baseline and counselling characteristics stratified by 3-month medication adherence

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