Assessment of self-medication in patients with rheumatoid arthritis referred to Rafsanjan Rheumatology Clinic during the COVID-19 pandemic

The COVID-19 disease has affected patients with rheumatoid arthritis (RA). Drug adherence is essential for RA control. This study investigated self-medication among RA patients in the COVID-19 pandemic. This cross-sectional study was performed on 288 patients with RA referred to the Rheumatology Clinic of Rafsanjan in 2021. Data were extracted by a checklist. Patients were examined and the type of used drugs, drug dose, and dose change were recorded. Inclusion criteria were diagnosis of rheumatoid arthritis, care during the last year and being over 16 years of age. Data were analyzed using SPSS/18 software. The mean ± SD of patients' age was 53.3 ± 12.6 years and 53.8% of patients were male. The mean ± SD duration of the disease was 7.04 ± 6.37 years. Self-medication was observed in all drugs, where Alendronate (100.0%, n = 13), Folic Acid (100.0%, n = 7), Methotrexate (94.1%, n=32), and Prednisolone (89.3%, n = 25) had the highest frequency of changes among other drugs (P value < 0.001). The mean ± SD dose of Hydroxychloroquine increased from 1358.5 ± 304.4 to 1368.0 ± 336.2 mg before and during the COVID-19 pandemic (P value = 0.319). The odd ratio of self[1]medication was higher in women (OR = 6.130, 95%CI: 2.915-12.993), RA patients with academic education (OR = 2.727, 95%CI: 1.037- 7.166), and lower in RA patients with a governmental occupation (OR = 0.277, 95%CI: 0.086-0.893). Self-medication of rheumatoid arthritis drugs may occur due to the positive effect of these drugs on COVID-19 disease and further reduced drug accessibility. It is necessary to plan to prevent self-medication in these patients by physicians.