Skip to main content

Advertisement

SpringerLink
Log in

Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus

  • Original Article
  • Published:
Clinical Rheumatology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Bond WSHD (1991) Detection methods and strategies for improving medication compliance. Am J Hosp Pharm 48(9):1978–1988 Sep

    PubMed  CAS  Google Scholar 

  2. Viller F, Guillemin F, Briancon S, Moum T, Suurmeijer T, van den HW (1999) Compliance to drug treatment of patients with rheumatoid arthritis: a 3 year longitudinal study. J Rheumatol 26(10):2114–2122 Oct

    PubMed  CAS  Google Scholar 

  3. Deyo RA, Inui TS, Sullivan B (1981) Noncompliance with arthritis drugs: magnitude, correlates, and clinical implications. J Rheumatol 8(6):931–936 Nov

    PubMed  CAS  Google Scholar 

  4. Lee P, Tan LJ (1979) Drug compliance in outpatients with rheumatoid arthritis. Aust N Z J Med 9(3):274–277 Jun

    PubMed  CAS  Google Scholar 

  5. Pullar T, Peaker S, Martin MF, Bird HA, Feely MP (1988) The use of a pharmacological indicator to investigate compliance in patients with a poor response to antirheumatic therapy. Br J Rheumatol 27(5):381–384 Oct

    Article  PubMed  CAS  Google Scholar 

  6. Mosley-Williams A, Lumley MA, Gillis M, Leisen J, Guice D (2002) Barriers to treatment adherence among African American and white women with systemic lupus erythematosus. Arthritis Rheum 47(6):630–638 Dec 15

    Article  PubMed  Google Scholar 

  7. Balant LP, Balant-Gorgia EA (2000) Cultural differences: implications on drug therapy and global drug development. Int J Clin Pharmacol Ther 38(2):47–52 Feb

    PubMed  CAS  Google Scholar 

  8. Charles H, Good CB, Hanusa BH, Chang CC, Whittle J (2003) Racial differences in adherence to cardiac medications. J Natl Med Assoc 95(1):17–27 Jan

    PubMed  Google Scholar 

  9. Dunbar-Jacob J, Holmes JL, Sereika S, Kwoh CK, Burke LE, Starz TW et al (2004) Factors associated with attrition of African Americans during the recruitment phase of a clinical trial examining adherence among individuals with rheumatoid arthritis. Arthritis Rheum 51(3):422–428 Jun 15

    Article  PubMed  Google Scholar 

  10. Arnett FC, Edworthy SM, Bloch DA, McShane DJ, Fries JF, Cooper NS et al (1988) The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 31(3):315–324 Mar

    Article  PubMed  CAS  Google Scholar 

  11. Tan EM, Cohen AS, Fries JF, Masi AT, McShane DJ, Rothfield NF et al (1982) The 1982 revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 25(11):1271–1277 Nov

    Article  PubMed  CAS  Google Scholar 

  12. 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 30:2469–2475

    PubMed  Google Scholar 

  13. Chesney MA, Ickovics JR, Chambers DB, Gifford AL, Neidig J, Zwickl B et al (2000) Self-reported adherence to antiretroviral medications among participants in HIV clinical trials: the AACTG adherence instruments. Patient Care Committee & Adherence Working Group of the Outcomes Committee of the Adult AIDS Clinical Trials Group (AACTG). AIDS Care 12(3):255–266 Jun

    Article  PubMed  CAS  Google Scholar 

  14. Barber N, Parsons J, Clifford S, Darracott R, Horne R, Coons SJ (2004) Patients’ problems with new medication for chronic conditions. Qual Saf Health Care 13(3):172–175 Jun 1

    Article  PubMed  CAS  Google Scholar 

  15. Osterberg L, Blaschke T (2005) Adherence to medication. N Engl J Med 353(5):487–497 Aug 4

    Article  PubMed  CAS  Google Scholar 

  16. de Klerk E, van der HD, van der TH, van der LS (1999) Development of a questionnaire to investigate patient compliance with antirheumatic drug therapy. J Rheumatol 26(12):2635–2641 Dec

    PubMed  Google Scholar 

  17. Graveley EA, Oseasohn CS (1991) Multiple drug regimens: medication compliance among veterans 65 years and older. Res Nurs Health 14(1):51–58 Feb

    Article  PubMed  CAS  Google Scholar 

  18. Hill MN, Bone LR, Kim MT, Miller DJ, Dennison CR, Levine DM (1999) Barriers to hypertension care and control in young urban black men. Am J Hypertens 12(1O Pt 1):951–958 Oct

    Article  PubMed  CAS  Google Scholar 

  19. Neff JA, Crawford SL (1998) The Health Belief Model and HIV risk behaviours: a causal model analysis among Anglos, African-Americans and Mexican-Americans. Ethn Health 3(4):283–299 Nov

    Article  PubMed  CAS  Google Scholar 

  20. Pearlman DN, Rakowski W, Ehrich B, Clark MA (1996) Breast cancer screening practices among black, Hispanic, and white women: reassessing differences. Am J Prev Med 12(5):327–337 Sep

    PubMed  CAS  Google Scholar 

  21. Garcia Popa-Lisseanu MG, Greisinger A, Richardson M, O'Malley KJ, Janssen NM, Marcus DM et al (2005) Determinants of treatment adherence in ethnically diverse, economically disadvantaged patients with rheumatic disease. J Rheumatol 32(5):913–919 May

    PubMed  Google Scholar 

  22. Petri M, Perez-Gutthann S, Longenecker JC, Hochberg M (1991) Morbidity of systemic lupus erythematosus: role of race and socioeconomic status. Am J Med 91(4):345–353 Oct

    Article  PubMed  CAS  Google Scholar 

  23. Glave-Testino C, Cardiel MH, Arce-Salinas A, Alarcon-Segovia D (1994) Factors associated with disease severity in Mexican patients with rheumatoid arthritis. Clin Exp Rheumatol 12(6):589–594 Nov

    PubMed  CAS  Google Scholar 

Download references

Acknowledgment

This study is supported by a grant from the National Institute for Arthritis, Musculoskeletal and Skin Disorders (NIAMS; R01 AR47858) and, in part, by the Houston Center for Quality of Care and Utilization Studies, Health Services Research and Development Service, Office of Research and Development, Department of Veterans Affairs. Dr. Suarez-Almazor has a K24 career award from NIAMS and is the Director of the Houston Center for Education and Research on Therapeutics funded by the Agency for Health Quality and Research (U18 HS016093).

Author information

Authors and Affiliations

  1. University of Texas M.D Anderson Cancer Center, Anderson 1400 Holcombe Boulevard Unit 437, Houston, TX, 77030, USA

    Araceli Garcia-Gonzalez, Marsha Richardson, Vanessa Cox, Michael A. Kallen, Namieta Janssen, Donald M. Marcus & Maria E. Suarez-Almazor

  2. Baylor College of Medicine, Houston, TX, USA

    Maria Garcia Popa-Lisseanu & Bernard Ng

  3. Department of Veteran Affairs, Houston, TX, USA

    Bernard Ng

  4. University of Texas Health Sciences Center, Houston, TX, USA

    John D. Reveille

Authors
  1. Araceli Garcia-Gonzalez
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Marsha Richardson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Maria Garcia Popa-Lisseanu
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Vanessa Cox
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Michael A. Kallen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Namieta Janssen
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Bernard Ng
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Donald M. Marcus
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. John D. Reveille
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Maria E. Suarez-Almazor
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Maria E. Suarez-Almazor.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Garcia-Gonzalez, A., Richardson, M., Garcia Popa-Lisseanu, M. et al. Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus. Clin Rheumatol 27, 883–889 (2008). https://doi.org/10.1007/s10067-007-0816-6

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10067-007-0816-6

Keywords

Search

Navigation