{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:34:49Z","timestamp":1786649689476,"version":"build-2736575974"},"reference-count":12,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>The objective of this study was to evaluate factors associated with glucocorticoid (GC) self-medication during the COVID-19 pandemic and to describe its clinical consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Self-medication practices and disease activity were assessed in rheumatoid arthritis patients before and after the hospital closure due to the COVID-19 pandemic through telephone survey and clinical record review. GC toxicity was evaluated using a modified Glucocorticoid Toxicity Index (GTI). Comparisons were performed using statistical tests as appropriate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Findings:<\/jats:title>\n                    <jats:p>\n                      Following the hospital\u2019s reopening, 51% of patients had modified their GC dose (\u201cchangers\u201d), while 49% maintained the same dose (\u201cnonchangers\u201d). Lower adherence to methotrexate (MTX) was significantly associated with self-medication (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). Self-medication correlated with increased C-reactive protein levels and pain perception but did not alter clinical activity score. The GTI revealed more infections and neurological effects in the changer group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>MTX nonadherence was the primary determinant of GC self-medication during the hospital closure. Although transient, this behavior was associated with increased inflammatory markers, pain perception, and adverse events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/jrpp.jrpp_30_25","type":"journal-article","created":{"date-parts":[[2025,10,6]],"date-time":"2025-10-06T11:03:15Z","timestamp":1759748595000},"page":"120-125","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Factors Associated with Self-medication with Glucocorticoids during the COVID-19 Pandemic and Their Clinical Consequences in Rheumatoid Arthritis Patients: A Before-and-after Study"],"prefix":"10.4103","volume":"14","author":[{"given":"Adriana-Alejandra","family":"Moctezuma-Ocampo","sequence":"first","affiliation":[{"name":"Cytokine and Autoinmmunity Department, Faculty of Pharmacy, Universidad Aut\u00f3noma del Estado de Morelos, Cuernavaca, Morelos, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel-Xavier","family":"Xibill\u00e9-Friedmann","sequence":"additional","affiliation":[{"name":"Rheumatology Department, Hospital General de Cuernavaca \"Dr. Jos\u00e9 G. Parres\", IMSS-Bienestar, Morelos, Cuernavaca, Morelos, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9-Iv\u00e1n","family":"Mart\u00ednez-Rivera","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, Universidad Aut\u00f3noma del Estado de Morelos, Cuernavaca, Morelos, M\u00e9xico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana-Lizbeth","family":"G\u00f3mez-Galicia","sequence":"additional","affiliation":[{"name":"Pharmaceutical Epidemiology Department, Faculty of Pharmacy, Universidad Aut\u00f3noma del Estado de Morelos, Cuernavaca, Morelos, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9-Luis","family":"Montiel-Hern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Cytokine and Autoinmmunity Department, Faculty of Pharmacy, Universidad Aut\u00f3noma del Estado de Morelos, Cuernavaca, Morelos, Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"R1-20251006","doi-asserted-by":"crossref","first-page":"1197","DOI":"10.1002\/jcph.2292","article-title":"Investigation of the effect of oral selenium on the reduction of clinical symptoms and joint pain in patients with rheumatoid arthritis in the Iranian population","volume":"63","author":"Mehrpooya","year":"2023","journal-title":"J Clin Pharmacol"},{"key":"R2-20251006","doi-asserted-by":"crossref","first-page":"2019","DOI":"10.1016\/S0140-6736(23)01525-8","article-title":"Rheumatoid arthritis","volume":"402","author":"Di Matteo","year":"2023","journal-title":"Lancet"},{"key":"R3-20251006","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1136\/ard-2023-224270","article-title":"Initial glucocorticoid bridging in rheumatoid arthritis: Does it affect glucocorticoid use over time?","volume":"83","author":"van 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