Top

Published in:

01-06-2015 | Original Article - Observational Research

Determinants of medication non-adherence in Egyptian patients with systemic lupus erythematosus: Sharkia Governorate

Authors: Amal B. Abdul-Sattar, Sahar A. Abou El Magd

Published in: Rheumatology International | Issue 6/2015

Abstract

The aim of the study was to identify the determinants of adherence to medication among Egyptian patients with SLE. A single-center cross-sectional study was conducted among Egyptian patients with SLE. Adherence to medication was measured via The Compliance Questionnaire for Rheumatology-19, and the patients were classified as non-adherers if they were taking <80 % of their medication correctly. Predictors of adherence to SLE medication were determined by multiple logistic regressions. The mean age of participants was 30.9 ± 11.7 years. Females constituted 95 % of all participants. Thirty-eight (%) were taking <80 % of their medication correctly. On logistic regression analysis, the significant independent predictors of medication non-adherence were lower educational level (OR 5.6, 95 % CI 2.1–7.3, P < 0.001), very low and low socioeconomic status (OR 2.6, 95 % CI 1.6–4.3, P < 0.04), rural residency (OR 3.4, 95 % CI 1.4–5, P < 0.01), more number of medications (OR 3.2, 95 % CI 2.3–6.9, P < 0.01), and higher depressive symptoms (OR 3.7, 95 % CI 1.4–10.2, P < 0.001). The adherence rate reported in this study was quite low. Appropriate adherence enhancing intervention strategies targeted at reducing pill load, minimizing depressive symptoms, and ensuring an uninterrupted access to free services regimen for patients with low socioeconomic status is strongly recommended. More attention should be given to SLE patients who live in rural regions.

Daleboudt GM, Broadbent E, Berger SP, Kaptein AA (2011) Illness perceptions in patients with systemic lupus erythematosus and proliferative lupus. Lupus 20(3):290–298CrossRefPubMed

Kulczycka L, Sysa-Jedrzejowska A, Robak E (2009) Life satisfaction together with positive and negative aspects in Polish patients with systemic lupus erythematosus. J Eur Acad Dermatol Venereol 23(3):251–255CrossRefPubMed

Navarrete-Navarrete N, Peralta-Ramírez MI, Sabio JM, Martínez-Egea I, Santos-Ruiz A, Jiménez-Alonso J (2010) Quality-of-life predictor factors in patients with SLE and their modification after cognitive behavioural therapy. Lupus 19(14):1632–1639CrossRefPubMed

Isenberg D, Rahman A (2006) Systemic lupus erythematosus—2005 annus mirabilis? Nat Clin Pract Rheumatol 2:145–152CrossRefPubMed

Grigor C, Capell H, Stirling A et al (2004) Effect of a treatment strategy of tight control for rheumatoid arthritis (the TICORA study): a single-blind randomised controlled trial. Lancet 364:263–269CrossRefPubMed

Gerth WC (2002) Compliance and persistence with newer antihypertensive agents. Curr Hypertens Rep 4(6):424–433CrossRefPubMed

Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353(5):487–497CrossRefPubMed

Horne R (2006) Compliance, adherence, and concordance: implications for asthma treatment. Chest 130:65S–72SCrossRefPubMed

Koneru S, Shishov M, Ware A et al (2007) Effectively measuring adherence to medications for systemic lupus erythematosus in a clinical setting. Arthritis Rheum 57:1000–1006CrossRefPubMed

10.

World Health Organization (2003) Adherence to long-term therapies—evidence for action. WHO Library Cataloguing-in-Publication Data, Geneva, pp 1–211

11.

Masood S, Jayne D, Karim Y (2009) Beyond immunosuppression—challenges in the clinical management of lupus nephritis. Lupus 18(2):106–115CrossRefPubMed

12.

Pons-Estel GJ, Alarcón GS, Scofield L, Reinlib L, Cooper GS (2009) Understanding the epidemiology and progression of systemic lupus erythematosus. Semin Arthritis Rheum 39(4):257–268CrossRefPubMedCentralPubMed

13.

Viller F, Guillemin F, Briancon S et al (1999) Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study. J Rheumatol 26:2114–2122PubMed

14.

Park DC, Hertzog C, Leventhal H et al (1999) Medication adherence in rheumatoid arthritis patients: older is wiser. J Am Geriatr Soc 47:172–183CrossRefPubMed

15.

Goodacre LJ, Goodacre JA (2004) Factors influencing the beliefs of patients with rheumatoid arthritis regarding disease-modifying medication. Rheumatology (Oxford) 43:583–586CrossRef

16.

Treharne GJ, Lyons AC, Hale ED et al (2006) ‘Compliance’ is futile but is ‘concordance’ between rheumatology patients and health professionals attainable? Rheumatology (Oxford) 45:1–5CrossRef

17.

Tan EM, Cohen AS, Fries JF et al (1982) The revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25:1271–1277CrossRefPubMed

18.

Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725CrossRefPubMed

19.

de Klerk E, van der Heijde D, van der Tempel H, van der Linden S (1999) Development of a questionnaire to investigate patient compliance with antirheumatic drug therapy. J Rheumatol 14(12):2635–2641

20.

de Klerk E, van der Heijde D, Landewe R, van der Tempel H, van der Linden S (2003) The compliance–questionnaire–rheumatology compared with electronic medication event monitoring: a validation study. J Rheumatol 14(11):2469–2475

21.

Garcia-Gonzalez A, Richardson MG, Popa-Lisseanu M et al (2008) Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus. Clin Rheumatol 27(7):883–889CrossRefPubMed

22.

El-Gilany A, El-Wehady A, El-Wasify M (2012) Updating and validation of the socioeconomic status scale for health research in Egypt. East Mediterr Health J 18(9):962–968PubMed

23.

Bae SC, Koh HK, Chang DK, Kim MH, Park JK, Kim SY (2001) Reliability and validity of systemic lupus activity measure-revised (SLAM-R) for measuring clinical disease activity in systemic lupus erythematosus. Lupus 10:405–409CrossRefPubMed

24.

Yazdany J, Yelin EH, Panopalis P, Trupin L, Julian L, Katz PP (2008) Validation of the systemic lupus erythematosus activity questionnaire in a large observational cohort. Arthritis Rheum 59:136–143CrossRefPubMedCentralPubMed

25.

Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–401CrossRef

26.

Boyd JH, Weissman MM, Thompson WD, Myers JK (1982) Screening for depression in a community sample. Understanding the discrepancies between depression symptom and diagnostic scales. Arch Gen Psychiatry 39(10):1195–1200CrossRefPubMed

27.

McDowell I (2006) Measuring health: a guide to rating scales and questionnaires, vol 3. Oxford University Press, USACrossRef

28.

Martens MP, Parker JC, Smarr KL, Hewett JE, Slaughter JR, Walker SE (2003) Assessment of depression in rheumatoid arthritis: a modified version of the center for epidemiologic studies depression scale. Arthritis Rheum 49:549–555CrossRefPubMed

29.

Ghubash R, Daradkeh TK, Al Naseri KS, Al Bloushi NB, Al Daheri AM (2000) The performance of the Center for Epidemiologic Study Depression Scale (CES-D) in an Arab female community. Int J Soc Psychiatry 46(4):241–249CrossRefPubMed

30.

Chambers SA, Raine R, Rahman A, Isenberg D (2009) Why do patients with systemic lupus erythematosus take or fail to take their prescribed medications? A qualitative study in a UK cohort. Rheumatology 48(3):266–271CrossRefPubMed

31.

Sailler L, Puissant B, Méliani P et al (2007) Blood concentrations of hydroxychloroquine and its desethyl derivative correlate negatively with the percentage of CD45RO⁺ cells among CD4⁺ lymphocytes in hydroxychloroquine-treated lupus patients. Ann NY Acad Sci 1108:41–50CrossRefPubMed

32.

Julian LJ, Yelin E, Yazdany J et al (2009) Depression, medication adherence, and service utilization in systemic lupus erythematosus. Arthritis Rheum 61(2):240–246CrossRefPubMedCentralPubMed

33.

van den Bemt BJ, van den Hoogen FH, Benraad B, Hekster YA, van Riel PL, van Lankveld W (2009) Adherence rates and associations with nonadherence in patients with rheumatoid arthritis using disease modifying antirheumatic drugs. J Rheumatol 3610:2164–2170CrossRef

34.

Cramer J, Rosenheck R, Kirk G, Krol W, Krystal J (2003) Medication compliance feedback and monitoring in a clinical trial: predictors and outcomes. Value Health 6:566–573CrossRefPubMed

35.

Claxton AJ, Cramer J, Pierce C (2001) A systematic review of the associations between dose regimens and medication compliance. Clin Ther 23:1296–1310CrossRefPubMed

36.

de Thurah A, Norgaard M, Harder I, Stengaard-Pedersen K (2010) Compliance with methotrexate treatment in patients with rheumatoid arthritis: influence of patients’ beliefs about the medicine. A prospective cohort study. Rheumatol Int 30(11):1441–1448CrossRefPubMed

37.

Tuncay R, Eksioglu E, Cakir B, Gurcay E, Cakci A (2007) Factors affecting drug treatment compliance in patients with rheumatoid arthritis. Rheumatol Int 278:743–746CrossRef

38.

Treharne GJ, Lyons AC, Kitas GD (2004) Medication adherence in rheumatoid arthritis: effects of psychosocial factors. Psychol Health Med 93:337–349CrossRef

39.

Contreras-Yanez I, De Leon SP, Cabiedes J, Rull-Gabayet M, Pascual-Ramos V (2010) Inadequate therapy behavior is associated to disease flares in patients with rheumatoid arthritis who have achieved remission with disease-modifying antirheumatic drugs. Am J Med Sci 3404:282–290CrossRef

40.

Lorish CD, Richards B, Brown S (1989) Missed medication doses in rheumatic arthritis patients: intentional and unintentional reasons. Arthritis Care Res 21:3–9CrossRef

41.

Salt E, Frazier SK (2010) Adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis: a narrative review of the literature. Orthop Nurs 29(4):260–275CrossRefPubMedCentralPubMed

42.

Lu CL, Williams KM, Day OR (2007) The funding and use of high-cost medicines in Australia: the example of anti-rheumatic biological medicines. Aust NZ Health Policy 4:1–11CrossRef

43.

Potter T, Mulherin D, Pugh M (2002) Early intervention with disease-modifying therapy for rheumatoid arthritis: where do the delays occur? Rheumatology 41:953–955CrossRefPubMed

44.

Maradit-Kremers H, Nicola PJ, Crowson CS, O’Fallon WM, Gabriel SE (2006) Patient, disease, and therapy-related factors that influence discontinuation of disease-modifying antirheumatic drugs: a population-based incidence cohort of patients with rheumatoid arthritis. J Rheumatol 14(2):248–255

45.

Gehi A, Haas D, Pipkin S, Whooley MA (2005) Depression and medication adherence in outpatients with coronary heart disease: findings from the heart and soul study. Arch Intern Med 165:2508–2513CrossRefPubMedCentralPubMed

46.

Mohr DC, Goodkin DE, Likosky W, Gatto N, Baumann KA, Rudick RA (1997) Treatment of depression improves adherence to interferon β-1b therapy for multiple sclerosis. Arch Neurol 54:531–533CrossRefPubMed

47.

Wong M, Mulherin D (2007) The influence of medication beliefs and other psychosocial factors on early discontinuation of disease-modifying anti-rheumatic drugs. Musculoskelet Care 5:148–159CrossRef

Title: Determinants of medication non-adherence in Egyptian patients with systemic lupus erythematosus: Sharkia Governorate
Authors: Amal B. Abdul-Sattar
Sahar A. Abou El Magd
Publication date: 01-06-2015
Publisher: Springer Berlin Heidelberg
Published in: Rheumatology International / Issue 6/2015
Print ISSN: 0172-8172
Electronic ISSN: 1437-160X
DOI: https://doi.org/10.1007/s00296-014-3182-0

Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Reserve your place

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin

Prof. Florian Limbourg

Prof. Anoop Chauhan

Developed by: Springer Medicine

Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Please log in to get access to this content

Other articles of this Issue 6/2015

Glucocorticoid use is associated with increase in HDL and no change in other lipids in rheumatoid arthritis patients

Retro-orbital granuloma associated with granulomatosis with polyangiitis: a series of nine cases

What type of different clinical manifestations can cardiac sarcoidosis present?

Ankle pain in hereditary multiple exostoses: a case report

Relationships between body composition analysis measures in Greek women and US white women

Meta-analysis of associations between functional HLA-G polymorphisms and susceptibility to systemic lupus erythematosus and rheumatoid arthritis

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

At a glance: The STEP trials