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Ruth Alexandra Castiblanco-Montañez,1 Diana Buitrago-Garcia,2,3 Adriana Arévalo Velandia,4 Julián David Garzón-Cepeda,4 Fernando Rodríguez-Florido,5 Guillermo Sánchez Vanegas,2,6 Pedro Santos-Moreno5 1Care Perspectives Research Group, Faculty of Nursing, Fundación Universitaria de Ciencias de la Salud – FUCS, Bogotá, Colombia; 2Clinical Epidemiology Graduate Program, Fundación Universitaria de Ciencias de la Salud – FUCS, Bogotá, Colombia; 3Institute of Social and Preventive Medicine (ISPM) and Graduate School for Health Sciences, University of Bern, Bern, Switzerland; 4Faculty of Nursing, Fundación Universitaria de Ciencias de la Salud – FUCS, Bogotá, Colombia; 5BIOMAB IPS -Center for Rheumatoid Arthritis, Bogotá, Colombia; 6Clinical Epídemiology, Hospital Universitario Mayor-Méderi, Universidad del Rosario, Bogotá, ColombiaCorrespondence: Pedro Santos-Moreno, BIOMAB IPS -Center for Rheumatoid Arthritis, Calle 48 # 13-86, Bogotá, Colombia, Tel +57 3208094232, Email pedrosantosmoreno@hotmail.comIntroduction: Rheumatoid arthritis is a chronic inflammatory disease diagnosed in a productive stage of life. Patients with RA experience changes in their musculoskeletal system, overall health and quality of life. It has been identified that patients with RA do not have appropriate knowledge about their condition. Educational programs can provide new knowledge, accompaniment, and closer follow-up to improve empowerment and quality of life in patients with RA.Purpose: To describe rheumatoid arthritis patients’ experiences, perceptions, and expectations when enrolling on a multicomponent educational program in a specialized RA setting.Patients and Methods: A qualitative study was done. Patients with RA who attended a specialized center and enrolled in an educational program participated in two focus groups. The focus group discussions and the interviews were recorded, transcribed verbatim, analyzed, and emerging themes were constructed.Results: Thirty-one participants were included in the focus groups. The median age was 60 years IQR (54– 67), 92% were female. Two relevant categories emerged: first, the experience of being diagnosed with RA. Second, the program’s ability to empower participants with knowledge and the possibility of transferring knowledge to other patients with the same condition. In addition, patients gave a high score to the expectations regarding the educational program.Conclusion: Understanding patients’ expectations when enrolling in an educational program allows educators and clinicians to understand their motivations to create tailored programs that can contribute to acquiring empowerment in the educational process and managing their disease. Stakeholders should consider patients’ expectations when implementing these interventions for patients with RA to adapt the intervention according to the patient’s context and needs, which will directly affect the patient’s adherence and lead to better use and allocation of resources for educational activities.Keywords: qualitative research, patient preference, patient education

Pedro Santos-Moreno,1 Guillermo Sánchez-Vanegas,2 Angélica Monterrosa-Blanco,3 Gabriel-Santiago Rodríguez-Vargas,1 Manuel Rivero,1 Pedro Rodriguez,1 Omar-Javier Calixto,4 Adriana Rojas-Villarraga,5 Carlos Alberto Castro3 1Rheumatology Department, Biomab IPS, Bogotá, Colombia; 2Scientific Direction Department, Hospital Universitario Mayor Mederi, Universidad del Rosario, Bogotá, Colombia; 3Research and Health Education Department, Comprehensive Solutions for Health Research and Education-SIIES, Bogotá, Colombia; 4Rheumatology and Immunology Department, Hospital Militar Central, Bogotá, Colombia; 5Research Institute, Fundación Universitaria de Ciencias de la Salud–FUCS, Bogotá, ColombiaCorrespondence: Pedro Santos-Moreno, Rheumatology Department, Biomab IPS, Calle 48 # 13-86, Bogotá, Colombia, Tel +57 320 8094232, Email pedrosantosmoreno@hotmail.comPurpose: To assess, in a cohort of patients with rheumatoid arthritis (RA) treated with subcutaneous antitumor necrosis factor drugs (anti-TNFs), the levels of treatment adherence before and after implementing a comprehensive care model (CCM).Patients and Methods: An observational study including RA patients under treatment with subcutaneous anti-TNFs (adalimumab, etanercept, and golimumab) selected at convenience was performed; a sample size of 125 patients was calculated. The outcome variable was adherence assessed with the Compliance Questionnaire on Rheumatology (CQR19), measured before and after implementing a CCM. Descriptive and bivariate analyses were performed comparing adherence before and after applying the model (Wilcoxon and McNemar’s Chi2 test). For multivariate analysis, a generalized linear model adjusted for covariates was performed, where the difference in the proportion of adherence was the outcome measure.Results: A total of 131 RA patients were followed-up for 24 months; average age was 62 years, and 83.9% were women. The median of DAS28 at the beginning of the follow-up was 2.32, and the HAQ was 0.25. At baseline, 87.8% were adherent; after 24 months, 96.2% were adherent according to CQR19. At the end of follow-up, adherence increased with the three types of anti-TNFs treatment. In a matched model adjusted for clinical variables, the CCM was estimated to produce a 9.4% increase in the total percentage of adherent patients. Additionally, a statistically significant increase of 4.5% in the percentage of adherent patients treated with golimumab compared with etanercept and adalimumab was found.Conclusion: A CCM produced an important increase in the percentage of patients with rheumatoid arthritis adherent to treatment after 24 months of follow-up. It is noteworthy that Golimumab patients were more adherent when compared with other current anti-TNFs treatments.Keywords: rheumatoid arthritis, treatment adherence, comprehensive health care, antirheumatic agents, controlled before–after studies