Nonadherence to therapy common in SLE

Patients with systemic lupus erythematosus (SLE) are commonly nonadherent to therapy, according to a recent study published in the March 2011 issue of Arthritis Care & Research. The nonadherence is both intentional and unintentional.

Researchers from Leiden University Medical Center in The Netherlands studied 106 patients who were receiving at least 1 immunosuppressive agent to control their SLE. They obtained from the patients self-reported levels of adherence to therapy. Patients completed questionnaires that assessed associations between adherence and problems with cognitive functioning, beliefs about medicines, illness perceptions, emotional health, and disease characteristics.

For the total patient group, there was an 86.7% self-reported adherence rate. At least occasional nonadherence was reported by 46.2% of patients; 58.5% were at least occasionally unintentionally nonadherent.

The researchers determined the strongest predictors of (non)adherence were difficulties with cognitive functioning, concerns about adverse effects of medication, and younger age. Patients more likely to report low adherence were emotionally affected by their SLE. However, this was not a significant predictor after accounting for other variables; disease characteristics showed no relationship to measures of adherence.

Nonadherence may be reduced by targeting emotional and cognitive functioning and by fine-tuning doctor-patient communication to address patients' individual concerns about their medications, concluded the researchers.