Adherence to treatment in systemic lupus erythematosus patients

Diagnosis, Monitoring, and Treatment of Systemic Lupus Erythematosus: A Systematic Review of Clinical Practice Guidelines

“…Rates of nonadherence in SLE have been reported as high as 76% (43) and are associated with a higher risk of flare, morbidity, hospitalization, and poor renal outcome (44). Nonadherence to therapy as a cause of treatment failure is commonly seen in clinical practice (28) and may affect therapeutic decisions.…”

Therapeutic adherence in patients with systemic lupus erythematosus: a cross-sectional study

“…Therewith, the findings of the research showed variable rates of non-adherence among lupus patients, ranging from 3 to 76%, which assume that disease can and must be controlled on compliance to treatment by different methods because the treatment is prescribed in the long term, often throughout life, in various regimes and associations [3]. Patients are afraid of the side effects of treatment, and it persists the lack of communication with health care providers -doctor, nurse or pharmacist.…”

“…Totalizing all the data from the published literature we have selected the causes of non-adherence to treatment, which are the duration of the disease, age, educational level, the unemployed or household status, the high costs of treatment and investigations, the difficulty of completing numerous forms for pharmacies, other healthcare providers (neurologist, physiotherapist, physical therapist, etc. ), low self-efficacy, depression, low social support, inconvenient patient/doctor relationship, or distrust in doctor/public health system -barriers from health care system, the excessive use of alcohol, but also the irresponsibility of administering medication by avoiding taking tablets [1,3,4,5].…”

Routine Hydroxychloroquine Blood Concentration Measurement in Systemic Lupus Erythematosus Reaches Adulthood

“…In such a situation, blood HCQ levels help distinguish flares due to a lack of response to treatment (indication to change treatment) from those due to poor adherence to treatment (indication for education, etc.). As a consequence, such laboratory tests may avoid unnecessary or even dangerous regimen escalation 12 . Of note, results of an ongoing international study evaluating the extent of nonadherence in patients with SLE may emphasize the importance of this blood measurement (ClinicalTrials.gov: NCT01509989).…”

“…Such result is sometimes completely unexpected according to the physician's evaluation, particularly in very nice patients, who never miss a medical appointment and who conform perfectly to ophthalmological followup for HCQ. It is then of utmost importance to explain the benefit/risk ratio of HCQ, to discuss this result with the patient in a nonjudgmental way, bearing in mind how difficult it is to follow treatment over the long term, and how common nonadherence is 12 . Diagnosing nonadherence can then be considered as the first step to find solutions with the patients.…”