The Longer the Time of Disease, the Lower Adherence in Patients with Systemic Lupus Erythematosus (original) (raw)
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Patient Preference and Adherence, 2016
Medication adherence is essential for the control of symptoms and progression of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). The aim of the study was to investigate medication adherence in outpatients in treatment for RA and SLE in a university hospital in Brazil. This was a quantitative, cross-sectional analytical study. A total of 92 patients (55 RA patients and 37 SLE patients) were included in the study. A structured questionnaire for patients' interview and a form for collecting data from medical records were used for data collection. Adherence to drug treatment was assessed by the Morisky scale questionnaire. Data storage and analysis were performed using Epi Info 3.5.4 and statistical analysis by Stata/SE 12.0. The Pearson's chi-squared test and Fisher's exact test were applied for statistical and bivariate analyses. For multivariate data analysis the Poisson regression and the Wald test were used. The prevalence of adherence to drug treatment was 16.4% in RA patients and 45.9% in SLE patients. The final model of the multivariate analysis demonstrated associations between medication adherence and the following covariates for both RA and SLE groups: duration of therapy for rheumatic disease at the institution greater than 15 years and presence of more than six chronic comorbidities. The parameter "acquisition of medication at the high-cost pharmacy" was differently associated with medication adherence by group, and for the SLE group, living outside the city of Goiânia was a protective factor associated with adherence. This study demonstrated a low prevalence of medication adherence in patients in treatment for RA and SLE treated at this institution. These findings will serve as a base for future studies to elucidate what factors may positively or negatively affect medication adherence in this population. In addition, multidisciplinary approaches are needed to enhance adherence to drug treatment in patients in treatment for rheumatic disease.
2020
Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with an unknown aetiology. Although there is no definite treatment for this disease using proper prescribed medications, mortality and morbidity ratios could be decreased. The present study attempted to investigate adherence to medical treatment in patients suffering from SLE and to evaluate the related factors which influence adherence in order to improve patients’ prognoses. In this cross-sectional study, 132 patients with SLE who referred to the rheumatology clinic of Imam Khomeini Hospital (Tehran, Iran) over the period of 2012-2013 wereexamined using a questionnaire. The applied questionnaire included two parts; the first part pertained to adherence to medication treatments (CQR: compliance questionnaire rheumatology), and the second part was related to the factors involved in adherence to medication treatments. The obtained data were analyzed using the Chi-Square test and processed by SPSS16.0 software.In this...
Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study
Romanian Journal of Internal Medicine
Introduction. The aim of the research was the study of the adherence to treatment in patients with systemic lupus erythematosus. Methods. Cross-sectional study including 132 consecutive patients with systemic lupus erythematosus (SLICC, 2012 classification criteria). We collected clinical and socio-demographic data, socio-economic status; we assessed SLEDAI-2k disease activity, and estimated the adherence to treatment by Morisky questionnaire. Results. Our results demonstrated that low adherence to treatment in patients with systemic lupus erythematosus was in only 11.36% of patients, while 43.18% and 45.46% of the patients were scored as moderate and high adherence, respectively. A moderate/high adherence to treatment was associated to a high level of education (r = −0.51, p < 0.05, 95% CI = −0.25 to −0.66), low disease activity (r = 0.38, p < 0.05, 95% CI = 0.25 to 0.53) and low indices of physician global assessment (r = −0.31, p<0.05, 95% CI = −0.23 to −0.71). The sub-a...
Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus
Clinical Rheumatology, 2008
This study assessed self-reported adherence in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) from underserved healthcare settings. We conducted a cross-sectional survey of 102 ethnically diverse patients—70 with RA and 32 with SLE—attending rheumatology clinics at publicly funded hospitals in Houston, Texas; 43% were Hispanic, 32% African-American, and 25% White. Treatment adherence was evaluated using the compliance questionnaire rheumatology (CQR; 0, low adherence and 100, high adherence) and the questionnaire of the Adult AIDS Clinical Trials Group (AACTG). The patients were also asked how often they forgot to take their prescribed medications or discontinued them on their own. Mean patient age was 48.5 years; 75% were female, 32% were African-American, 43% Hispanic, and 25% White. Only one third reported never forgetting to take their medications; 40% reported having stopped their medications on their own because of side effects, and 20% because of lack of efficacy. Mean CQR score was 69.1 ± 10.5, suggesting moderate adherence overall. Differences were also observed across ethnic groups: 23% of ethnic minority patients had problems taking their medications at specified times compared to 11% of Whites (p = 0.03). Lower education and side effects were associated with lower adherence. No differences were observed between RA and SLE patients. Many patients with RA and SLE report problems with treatment adherence. These appear to be more prevalent in African Americans and Hispanics than Whites; the impact of decreased adherence on outcomes could be significant and should be considered when treating patients with RA and SLE.
Adherence To Medications In Systemic Lupus Erythematosus
JCR: Journal of Clinical Rheumatology, 2008
Background: Lack of adherence is a ubiquitous problem which can be a hindrance in the treatment of chronic conditions like systemic lupus erythematosus (SLE). Objectives: A random sample of 63 SLE patients attending rheumatology clinics associated with University Medical Centers were surveyed to measure level of adherence to their SLE medications and to identify the risk factors that have been associated previously with nonadherence to these medications. Methods: Information on traditional SLE outcomes was obtained by face-to-face interviews and medical record review. Various patient proposed strategies were identified to improve adherence to these medications. Results: When considering adherence estimates of Ն80% as representing sufficient adherence for achieving a therapeutic response, adherence to medications was only modestly adherent, likely limiting the effectiveness of the prescribed medication regimens. Based on pharmacy refill information 61% of the patients were sufficiently adherent to prednisone, 49% to hydroxychloroquine, and 57% to other immunosuppressant medications. Significant risk factors of insufficient adherence included being single, low educational level, presence of other comorbidities, limited comprehension of physician explanations and instructions, and having to take the medication more than one daily. Based on subject reports, busy life styles were among the most important barriers to adherence whereas pillboxes were considered most helpful for helping with medication adherence. Conclusion: Although lack of sufficient adherence to medications appears to be a multifactorial problem, improved communication between the healthcare provider and the patient, and less complicated medication regimens, may be especially suitable interventions to improve adherence to medications. *Nonadherent ϭ defined as adherence level (%) of Ͻ80%. † Sufficiently adherent ϩ defined as adherence level (%) of Ն80%.
Arthritis & Rheumatism, 2007
Objective. To assess the reliability and concurrent validity of the Medication Adherence Self-report Inventory (MASRI) when used in systemic lupus erythematosus (SLE), to investigate the predictive validity of the MASRI using pharmacy refill information as the criterion standard, and to propose a sensible approach to the screening for nonadherence in a clinical setting. Methods. Adherence to 2 medications (hydroxychloroquine and prednisone) was measured in 55 patients using the MASRI, pill counts, and physician ratings (MD scale). Adherence based on pharmacy refill information served as a criterion standard with nonadherence defined as adherence rates <80%. To determine test-rest reliability of the MASRI, 20 patients completed the measure twice within a 2-week period. Results. Using pharmacy information, 39% of the patients were nonadherent to prednisone and 51% to hydroxychloroquine. The MASRI had acceptable internal consistency (Cronbach's ␣ 0.7) and good reliability. Irrespective of the drug assessed, MASRI ratings were moderately correlated with patient adherence (pharmacy), supporting the concurrent validity of the MASRI. The combination of adherence estimation by MD scale rating at <85% and by MASRI at <90% was 87% sensitive and 86% specific for identifying patients who were nonadherent to prednisone. These cutoff values also appeared suitable for identifying nonadherence to hydroxychloroquine. Conclusion. The MASRI is a reliable measure of adherence to medications in SLE. The measure has concurrent and predictive validity. When combined with the MD scale, the MASRI appears to be a useful screening tool for nonadherence in patients with SLE that could be suitable for clinical practice.
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Purpose Medication non-adherence occurs frequently in individuals with systemic lupus erythematosus (SLE); proportions as high as 43-75% have been documented, depending on the methods of assessment. 1 The aim of this study was to determine factors that impact adherence to medications in a Swedish SLE population. Methods A cross-sectional study was conducted using survey data collected from individuals diagnosed with SLE from two Swedish tertiary referral centres (Karolinska and Örebro University Hospitals). The survey comprised validated questionnaires, including the 19-item Compliance Questionnaire of Rheumatology (CQR-19) that assesses rheumatic disease-specific medication adherence and the generic Medication Adherence Self-Report Inventory (MASRI), with which we assessed adherence to glucocorticoids (GCs) and antimalarial agents (AMAs) separately. The study participants were asked to report their beliefs in medications using the Beliefs about Medicines Questionnaire (BMQ), which contains one part dealing with the patient's specific medications and another part for medications in general. Health-related quality of life
Background: The need for ongoing treatment to manage immune-mediated inflammatory diseases is a challenge for health care providers, as there is always an attempt to achieve clinical remission as much as possible. Objective: This study aimed to estimate the prevalence of non-adherence to biological drugs and factors affecting it among patients in Duhok governorate-Iraq. Patients and Methods: A cross-sectional questionnaire-based study was conducted between December 2018 to October 2019 at the specialized center of rheumatic disease and medical rehabilitation in Duhok city. One hundred forty-four patients who lived in Duhok governorate out of 216 registered cases were included, each with the established disease for at least 12 months, and had been taking biological drugs (Etanercept, Infliximab, and Adalimumab) with or without conventional drugs for at least three months were involved in this study. Disease activity scales as appropriate to each disease were used, with using a medication adherence scale to assess the adherence to medications. Results: From the total of 144 patients included in this study, 134 (93.1%) of them were nonadherent compared to only 10 (6.9%) of patients who were adherent to medication intake. Significant associations existed between adherence to the medications and different factors. These factors with the corresponding percentages of non-adherence were as follows: age between 30-39 (34.3%), illiterate/ primary education (56.0%), unemployed (64.9%), no ability to buy biologic drugs (82.1%), etanercept users (71.6%) and (56.7%) were using biological drugs for less than four years. Conclusion and recommendation: With the existence of multiple factors effect on adherence to medications and due to the inconsistency of these factors, routine measurements of adherence to medications are essential in achieving the desired therapeutic goal.
The American Journal of the Medical Sciences, 2007
238 words) Background: International recommendations such as the CONSORT and International Conference on Harmonisation statements recognize patient adherence to prescribed treatment as an important aspect of a treatment's evaluation, but this issue is little assessed. Objectives: To evaluate how medication adherence was assessed and reported in recently published randomized controlled trials (RCTs). Material and Methods: All publications of RCTs assessing pharmacological treatments in 6 major chronic diseases published in high-impact-factor journals in 2003 and 2004 were selected from the Medline database. Two investigators analysed how medication adherence was assessed and reported. Results: A total of 192 publications were analyzed: 71 in HIV infection, 48 diabetes mellitus, 24 rheumatoid arthritis, 23 asthma, 15 hypertension, 7 osteoporosis, and 4 about 2 of these diseases. The assessment of medication adherence was documented in 69 (35.9%) publications, by counting pill intake in half of these.
Medication Non-Adherence in Systemic Lupus Erythematosus: A Systematic Review
Arthritis care & research, 2017
Medication non-adherence has not been well characterized in systemic lupus erythematosus (SLE). Our objective was to a conduct a systematic review of the literature examining the burden and determinants of medication non-adherence in SLE. We conducted a systematic search of MEDLINE (1946-2015), EMBASE (1974-2015), and WEB OF SCIENCE (1900-2015) databases and selected original studies of SLE patients that evaluated non-adherence to SLE therapies as the primary study outcome. We extracted information on: 1) study design, 2) sample size, 3) length of follow-up, 4) data sources, 5) type of non-adherence problem examined, 6) adherence measures and reported estimates and 7) determinants of adherence reported in multivariable analyses. After screening 4,111 titles, 11 studies met the inclusion criteria. Study sample sizes ranged from 32 to 246 patients and studies were categorized according to data source: self-report (5), electronic monitoring devices (1), clinical records from rheumatolo...