THU0626 Drug Adherence Impact on Systemic Lupus Erythematosus Patients Health
Authors: N.O. El-Azizi, A.A.M. Elhefny, M.A. Adb El-Rahman, M.A. Abou-Sheashaa
Journal: Annals of the Rheumatic Diseases (2016)

<h3>Background</h3> Poor adherence to therapeutic regimens is a common and expensive problem in patients with chronic diseases including SLE and is associated with a higher risk of flares, morbidity, hospitalizations and poor renal outcome. <h3>Objectives</h3> To measure the prevalence of adherence to drug treatment and analyze its associations with medications prescribed, disease characteristics, health professionals performance and services, and socio-demographic issues in patients with SLE to improve patients9 outcome and quality of service. <h3>Methods</h3> 100 SLE patients (with disease duration ≥1year) fulfilled the 2012 Systemic Lupus International Collaborating Clinics (SLICC) classification criteria recruited from the outpatient clinic and inpatient unit of Rheumatology &amp; Internal Medicine Department at Ain Shams University Hospitals. After consent all patients subjected to detailed history taking and full clinical examination, ANA, Anti-dsDNA titers, urine analysis, CBC, ESR, assessment of disease activity by SLEDAI and assessment of disease damage using the SLICC/ACR damage Index. All patients completed the screening adherence survey questionnaire for assessment of adherence to SLE medications (in the previous 6 months). <h3>Results</h3> The prevalence of adherence to drug treatment was 76%. The cause of adherence in 44.74% of adherent patients was their fear of disease worsening if medications were stopped, while feeling of moral obligation and responsibility to others (family members) was the cause of adherence in 28.95%. The reasons for non-adherence were forgetfulness (66.66%), high medications cost and difficulty to obtain medications (54%), then the large number of tablets prescribed (50%). 8.3% of our non-adherent patients stopped taking their drugs when they felt better. Source of getting medications was a highly statistically significant factor in adherence (P&lt;0.001) as 86.83% of the adherent patients were taking their medications at governmental expense, while 89.47% of non-adherent patients couldn9t afford. The non-adherent group had statistically significant higher disease duration (7.71 Vs 5.7 years) (P=0.032), higher prevalence of development of side effects (especially gastritis and peptic ulcer) (P=0.047) and higher SLEDAI (36.92 ±11.93 Vs 6.8±1.9) &amp; DI score (6.67±2.5 Vs 0.21±0.47) (P&lt;0.001) than the adherent group. 87.5% of non-adherent patients didn9t regularly attend the clinic (P=0.068); the median of number of drugs was 5.33 which was higher than that of adherent group 4.6 (P=0.015). 61% of our patients were satisfied with the standards of care at the clinic (P&lt;0.001). <h3>Conclusions</h3> Longer disease duration, higher drug cost, forgetfulness and the large number of prescribed drugs are risk factors for SLE patients non adherence. <h3>References</h3> Shumba C., Atuhaire L., Imakit R., et al. Missed Doses and Missed Appointments: Adherence to ART among Adult Patients in Uganda. ISRN AIDS. 2013; 270914: 1–7. Ward MM., Lotstein DS., Bush TM., et al. Psychosocial correlates of morbidity in women with systemic lupus erythematosus. J Rheumatol. 1999; 26: 2153–8. <h3>Acknowledgement</h3> We like to thanks all the patients sharing with us in this study. <h3>Disclosure of Interest</h3> None declared