Medication adherence is influenced by resilience in patients with systemic lupus erythematosus

Mendoza‐Pinto, Claudia; Garcı́a-Carrasco, Mario; Campos-Rivera, Sandra; Munguía‐Realpozo, Pamela; Etchegaray‐Morales, Ivet; Ayón-Aguilar, Jorge; Alonso-García, Norma Edith; Méndez‐Martínez, Socorro

doi:10.1177/09612033211004722

Cited by 17 publications

(21 citation statements)

References 38 publications

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“…Associations between resilience—defined as the process of positive adaptation to adversity—and medication adherence were previously reported in some chronic diseases, 10 , 27 , 28 but not in glaucoma. The positive association we observed between resilience and medication adherence in the period preceding the pandemic provides evidence for a protective role of resilience against nonadherence to ocular hypotensive medication.…”

Section: Discussionmentioning

confidence: 65%

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The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma

Racette¹,

Abu²,

Poleon³

et al. 2022

Ophthalmology

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Objective Emerging evidence suggests that the COVID-19 pandemic is disrupting health behaviors such as medication adherence. The objective of this study was to determine whether adherence to ocular hypotensive medication was affected by the pandemic and to identify factors associated with this change. Design In this cohort study, we used a controlled interrupted time series design in which the interruption was the declaration of the COVID-19 pandemic in the United States on March 13, 2020. The 300-day monitoring period, which evenly bracketed this declaration, started on October 16, 2019, and ended on August 10, 2020. Participants Patients with primary open-angle glaucoma enrolled in an ongoing longitudinal NIH-funded study initiated prior to the onset of the pandemic were selected if they were prescribed ocular hypotensive medication and had adherence data spanning the 300-day period. Methods We applied segmented regression analysis using a “slope change following a lag” impact model to obtain the adherence slopes in the periods preceding and following the segmentation. We compared the two slopes using the Davies test. Main outcome and measure The main outcome measure was daily adherence to ocular hypotensive medication—defined as the number of doses taken divided by the number of doses prescribed, expressed in percent. Adherence was measured objectively using Medication Event Monitoring System (MEMS) caps. We assessed the associations between change in adherence and demographic, clinical, and psychosocial factors. Results The sample included 79 patients (mean age, 71 years [SD, 8 years]). Segmented regression identified a breakpoint at day 28 following the declaration of the pandemic. The slope in the post-breakpoint period (-0.04%/day) was significantly different from zero ( P < 0.001) and from the slope in the period preceding the breakpoint (0.006%/day) ( P < 0.001). A significant positive association was observed between the Connor-Davidson Resilience score and the change in slope between the pre- and post-breakpoint periods ( P = 0.002). Conclusions and Relevance Adherence to ocular hypotensive medication worsened during the COVID-19 pandemic and appears to be related to patient resilience. This collateral consequence of the pandemic may translate into vision loss that may manifest beyond its containment.

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Section: Discussionmentioning

confidence: 65%

“…We assessed the association between demographic, clinical, and psychosocial factors and adherence in the periods preceding and following the onset of the pandemic. Psychosocial factors included resilience, 10 coping styles, 11 illness perception 12 and self-efficacy, 13 which have been associated with adherence and visual function.…”

mentioning

confidence: 99%

The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma

Racette¹,

Abu²,

Poleon³

et al. 2022

Ophthalmology

View full text Add to dashboard Cite

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“…Behaviorally, patients with high levels of resilience tended to have more health-promoting behaviors (healthy diet, participation in exercise, good medication adherence, lifestyle, adherence to breathing exercises, etc.) [ 39 , 82 , 83 , 84 ], which are the components of self-management. Content-wise, the components of the resilience scale (e.g., self-efficacy, coping skills) have been shown to improve self-management in COPD patients [ 9 , 85 ].…”

Section: Discussionmentioning

confidence: 99%

Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease

et al. 2021

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This study examined the mediating effect of resilience in the relationship between spirituality and self-management among older people with chronic obstructive pulmonary disease (COPD). The participants were 151 older people with COPD in four general hospitals in Jiangsu Province, China. Data were collected from September 2020 to May 2021 using a questionnaire developed by the investigator, the Function Assessment of Chronic Illness Therapy-Spiritual Scale (FACIT-SP-12), 10-item Connor-Davidson Resilience Scale (CD-RISC-10), and COPD Self-Management Scale (CSMS). One-way ANOVA and t-test were used to compare the level of self-management in patients with different sociodemographic and clinical characteristics. Partial correlation analysis was used to explore the correlation between spirituality, resilience, and self-management. Hierarchical multiple regression analyses were performed to examine the contribution of spirituality and resilience to the prediction of self-management. A bootstrapping test was implemented using the SPSS PROCESS macro to test the statistical significance of the mediating effect. There was a pairwise positive correlation between spirituality, resilience, and self-management. Resilience mediated the relationship between spirituality and self-management. These findings suggested that resilience interventions could be incorporated into future COPD self-management interventions to better improve self-management and health outcomes. Moreover, resilience should be an important component of healthy aging initiatives.

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“…Notably, increased levels of mental disorders tended to correlate with non-adherence, an association that has been previously shown especially for depression in several observational studies [ 25 , 26 , 27 , 28 , 63 , 64 ]. In this regard, anxiety and depression have been recognized as major determinants of the resilience [ 29 ] and illness perception [ 16 ] of lupus patients, which can both impact on compliance. Considering the prognostic implications of treatment adherence in terms of flares prevention and improved patient outcomes [ 65 ], these findings underline the importance of identifying and managing mental disorders in patients with SLE.…”

Section: Discussionmentioning

confidence: 99%

“…Of potential relevance is the association between depression and lower treatment adherence [ 25 , 26 , 27 , 28 ], a known driver for lupus flare and activity. This finding, however, lacks extensive confirmation or may be influenced by other factors such as ethnicity [ 29 , 30 , 31 , 32 ]. Therefore, evaluation of the frequency and determinants of mental disorders in different regions and clinical settings is important.…”

Section: Introductionmentioning

confidence: 99%

Persistence of Depression and Anxiety despite Short-Term Disease Activity Improvement in Patients with Systemic Lupus Erythematosus: A Single-Centre, Prospective Study

Nikoloudaki

Repa

Pitsigavdaki

et al. 2022

JCM

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Mental disorders such as anxiety and depression are prevalent in systemic lupus erythematosus (SLE) patients, yet their association with the underlying disease activity remains uncertain and has been mostly evaluated at a cross-sectional level. To examine longitudinal trends in anxiety, depression, and lupus activity, a prospective observational study was performed on 40 adult SLE outpatients with active disease (SLE Disease Activity Index [SLEDAI]-2K ≥ 3 [excluding serology]) who received standard-of-care. Anxiety and depression were determined at baseline and 6 months by the Hospital Anxiety and Depression Scale. Treatment adherence was assessed with the Morisky Medication Adherence Scale-4. Increased anxiety (median [interquartile range] HADS-A: 11.0 [7.8]) and depression (HADS-D: 8.0 [4.8]) were found at inclusion, which remained stable and non-improving during follow-up (difference: 0.0 [4.8] and −0.5 [4.0], respectively) despite reduced SLEDAI-2K by 2.0 (4.0) (p < 0.001). Among possible baseline predictors, paid employment—but not disease activity—correlated with reduced HADS-A and HADS-D with corresponding standardized beta-coefficients of −0.35 (p = 0.017) and −0.27 (p = 0.093). Higher anxiety and depression correlated with lower treatment adherence (p = 0.041 and p = 0.088, respectively). These results indicate a high-mental disease burden in active SLE that persists despite disease control and emphasize the need to consider socioeconomic factors as part of comprehensive patient assessment.

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Medication adherence is influenced by resilience in patients with systemic lupus erythematosus

Cited by 17 publications

References 38 publications

The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma

The Impact of the Coronavirus Disease 2019 Pandemic on Adherence to Ocular Hypotensive Medication in Patients with Primary Open-Angle Glaucoma

Resilience as a Mediator of the Association between Spirituality and Self-Management among Older People with Chronic Obstructive Pulmonary Disease

Persistence of Depression and Anxiety despite Short-Term Disease Activity Improvement in Patients with Systemic Lupus Erythematosus: A Single-Centre, Prospective Study

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