Background Lack of compliance to prescribed treatment is an ongoing problem in healthcare, leading to therapeutic failure and increased costs. Treatment compliance is defined by two related concepts: adherence and persistence during time. WHO estimates show that one every two patients with a chronic disease is not adherent. Studies on compliance in patients with Systemic Lupus Erythematosus (SLE) are scares, especially in third world countries. Low treatment compliance can be presumed.
Different tools had been developed to assess compliance, been the Compliance Questionnaire on Rheumatology (CQR) and the Morisky and Green questionnaire (MG) the most widely used.
The aim of this study is to evaluate the correlation between both questionnaires in SLE patients and to evaluate the relation between this instruments and SLE disease activity.
Methods Consecutive patients from our SLE unit were recruited in July and August 2018. The following variables were assessed: age, gender, ethnics, disease duration, occupation, monetary income, educational level, health insurance, place of residence, marital status, disease activity by SELENA-SLEDAI, accrual damage by SLICC-DI, current treatment and number of follow-up visits during the prior 12 months.
Compliance was assessed by CQR19 (compliant if 80%) and by MG (compliant if=0). Continual variables are expressed as mean and DS or median and interquartile range according to distribution. Categorical variables are presented as n(%). Association was assessed by chi2 or logistic regression as appropriate. Statistical analysis was performed using SPSS v21.
Results 70 consecutive patients were included. Baseline characteristics are shown in table 1.
Sensitivity and specificity for MG to detect lack of compliance was 90% and 42% respectively.
In our study, correlation between MG and CQR19 was found (RS=0.406, 0.01 bilateral; p=0.0005). However, none correlated with SELENA-SLEDAI, SLICC-DI. Both CQR19 and MG correlated with age (rs=0,272 :p=0023 and rs=0,471 :p=0,0000 respectively).
Conclusions MG, counting only four questions, is simpler to perform than CQR19. In our study, we found good correlation between both questionnaires.
Having found no correlation between compliance defined by either tool and SLE activity or accrual damage, we believe that the routine use of these tools has no influence in terms of therapeutic management in SLE patients.
Funding Source(s): None
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