Treatment Adherence and Disease Burden of Individuals with Rheumatic Diseases Admitted As Outpatients to a Large Rheumatology Center in Shanghai, China

Overview

Journal Patient Prefer Adherence

Date 2017 Oct 28

PMID 29075106

Citations 13

Authors

Le Zhang

Guo Hong Lu

Shuang Ye

Bin Wu

Yi Shen

Ting Li

Affiliations

Soon will be listed here.

Abstract

Purpose: The purpose of this study was to determine treatment adherence and disease burden, analyze detailed medication problems experienced by patients, and identify factors associated with adherence in patients with rheumatic diseases in China.

Patients And Methods: Patients with confirmed diagnoses of ankylosing spondylitis (AS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) were recruited, regardless of demographics, disease severity, and treatment characteristics. Adherence was assessed using the Compliance Questionnaire for Rheumatology and interview-based self-reports. A backwards-stepwise multivariate regression analysis was used to identify factors associated with adherence.

Results: We collected data on 252 patients who had a rheumatic disease and visited our outpatient clinic in January or February of 2017. There were 121 patients with SLE, 70 with RA, and 61 with AS. The overall adherence rate was 41.7%, with 48.7% for SLE patients, 38.6% for RA patients, and 31.1% for AS patients. The overall EuroQol (EQ)-index was 0.761; AS patients had the best EQ-index (0.792), followed by those with SLE (0.780) and RA (0.700). SLE patients also had greater annual direct costs (US$5,103.58) than RA or AS patients.

Conclusion: Overall, 41.7% of our rheumatic disease patients were adherent to treatment, lower than in many other parts of the world. This indicates that it is important to identify methods that improve adherence in this population. It is particularly important to improve the health status and reduce the disease burden of patients with SLE, the most common of the three rheumatic diseases we analyzed. Our results suggest that reminder tools may improve adherence. Further prospective research is needed to confirm whether reminder tools and other measures can improve patient compliance.

Citing Articles

Adherence to the antirheumatic drugs: a systematic review and meta-analysis.

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Health utility of patients with established rheumatoid arthritis and its influencing factors: a multi-center study in China.

Wan C, Huang Y, Wang Q, Wang P, Xi X Sci Rep. 2024; 14(1):14129.

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Factors associated with non-adherence to medications in systemic lupus erythematosus: Results from a Swedish survey.

Emamikia S, Gomez A, Adahl T, von Perner G, Enman Y, Chatzidionysiou K Lupus. 2024; 33(6):615-628.

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Patient self-reported experience and satisfaction with golimumab and etanercept treatments for rheumatic diseases: A cohort study.

Xia W, Zhou L, Gao W, Zhang Y, Si F, Bai F Medicine (Baltimore). 2024; 103(8):e36982.

PMID: 38394542 PMC: 11309713. DOI: 10.1097/MD.0000000000036982.

Annual Direct Cost and Cost-Drivers of Systemic Lupus Erythematosus: A Multi-Center Cross-Sectional Study from CSTAR Registry.

Wang H, Li M, Zou K, Wang Y, Jia Q, Wang L Int J Environ Res Public Health. 2023; 20(4).

PMID: 36834216 PMC: 9963905. DOI: 10.3390/ijerph20043522.

References

Costedoat-Chalumeau N, Pouchot J, Guettrot-Imbert G, Le Guern V, Leroux G, Marra D . Adherence to treatment in systemic lupus erythematosus patients. Best Pract Res Clin Rheumatol. 2013; 27(3):329-40. DOI: 10.1016/j.berh.2013.07.001. View

Prudente L, Diniz J, Ferreira T, Lima D, Silva N, Saraiva G . Medication adherence in patients in treatment for rheumatoid arthritis and systemic lupus erythematosus in a university hospital in Brazil. Patient Prefer Adherence. 2016; 10:863-70. PMC: 4878663. DOI: 10.2147/PPA.S79451. View

Fenerty S, West C, Davis S, Kaplan S, Feldman S . The effect of reminder systems on patients' adherence to treatment. Patient Prefer Adherence. 2012; 6:127-35. PMC: 3287416. DOI: 10.2147/PPA.S26314. View

Carter E, Barr S, Clarke A . The global burden of SLE: prevalence, health disparities and socioeconomic impact. Nat Rev Rheumatol. 2016; 12(10):605-20. DOI: 10.1038/nrrheum.2016.137. View

Rauscher V, Englbrecht M, van der Heijde D, Schett G, Hueber A . High degree of nonadherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis. J Rheumatol. 2015; 42(3):386-90. DOI: 10.3899/jrheum.140982. View

Xia Y, Yin R, Fu T, Zhang L, Zhang Q, Guo G . Treatment adherence to disease-modifying antirheumatic drugs in Chinese patients with rheumatoid arthritis. Patient Prefer Adherence. 2016; 10:735-42. PMC: 4862390. DOI: 10.2147/PPA.S98034. View

Jorgensen T, Kristensen L, Christensen R, Bliddal H, Lorenzen T, Hansen M . Effectiveness and drug adherence of biologic monotherapy in routine care of patients with rheumatoid arthritis: a cohort study of patients registered in the Danish biologics registry. Rheumatology (Oxford). 2015; 54(12):2156-65. DOI: 10.1093/rheumatology/kev216. View

Carls G, Li T, Panopalis P, Wang S, Mell A, Gibson T . Direct and indirect costs to employers of patients with systemic lupus erythematosus with and without nephritis. J Occup Environ Med. 2009; 51(1):66-79. DOI: 10.1097/JOM.0b013e31818a405a. View

Pierotti F, Palla I, Pippo L, Lorenzoni V, Turchetti G . BUDGET IMPACT ANALYSIS OF BELIMUMAB IN TREATING SYSTEMIC LUPUS ERYTHEMATOSUS. Int J Technol Assess Health Care. 2016; 32(5):348-354. DOI: 10.1017/S026646231600057X. View

10.

De Cuyper E, De Gucht V, Maes S, Van Camp Y, De Clerck L . Determinants of methotrexate adherence in rheumatoid arthritis patients. Clin Rheumatol. 2016; 35(5):1335-9. DOI: 10.1007/s10067-016-3182-4. View

11.

Lawson E, Trupin L, Yelin E, Yazdany J . Reasons for failure to receive pneumococcal and influenza vaccinations among immunosuppressed patients with systemic lupus erythematosus. Semin Arthritis Rheum. 2015; 44(6):666-71. PMC: 4464934. DOI: 10.1016/j.semarthrit.2015.01.002. View

12.

Duvdevany I, Cohen M, Minsker-Valtzer A, Lorber M . Psychological correlates of adherence to self-care, disease activity and functioning in persons with systemic lupus erythematosus. Lupus. 2010; 20(1):14-22. DOI: 10.1177/0961203310378667. View

13.

Bexelius C, Wachtmeister K, Skare P, Jonsson L, Vollenhoven R . Drivers of cost and health-related quality of life in patients with systemic lupus erythematosus (SLE): a Swedish nationwide study based on patient reports. Lupus. 2013; 22(8):793-801. DOI: 10.1177/0961203313491849. View

14.

Waimann C, Marengo M, de Achaval S, Cox V, Garcia-Gonzalez A, Reveille J . Electronic monitoring of oral therapies in ethnically diverse and economically disadvantaged patients with rheumatoid arthritis: consequences of low adherence. Arthritis Rheum. 2013; 65(6):1421-9. PMC: 3691007. DOI: 10.1002/art.37917. View

15.

Hromadkova L, Soukup T, cermakova E, Vlcek J . Drug compliance in patients with systemic scleroderma. Clin Rheumatol. 2012; 31(11):1577-83. DOI: 10.1007/s10067-012-2050-0. View

16.

Hill J, Bird H, Johnson S . Effect of patient education on adherence to drug treatment for rheumatoid arthritis: a randomised controlled trial. Ann Rheum Dis. 2001; 60(9):869-75. PMC: 1753835. View

17.

Osterberg L, Blaschke T . Adherence to medication. N Engl J Med. 2005; 353(5):487-97. DOI: 10.1056/NEJMra050100. View

18.

Daleboudt G, Broadbent E, McQueen F, Kaptein A . Intentional and unintentional treatment nonadherence in patients with systemic lupus erythematosus. Arthritis Care Res (Hoboken). 2010; 63(3):342-50. DOI: 10.1002/acr.20411. View

19.

Silva C, Aikawa N, Pereira R, Campos L . Management considerations for childhood-onset systemic lupus erythematosus patients and implications on therapy. Expert Rev Clin Immunol. 2015; 12(3):301-13. DOI: 10.1586/1744666X.2016.1123621. View

20.

Oliveira-Santos M . Erratum to: Effectiveness of pharmaceutical care for drug treatment adherence in patients with systemic lupus erythematosus in Rio de Janeiro, Brazil: study protocol for a randomized controlled trial. Trials. 2017; 18(1):96. PMC: 5335541. DOI: 10.1186/s13063-016-1766-6. View