RESEARCH - Why do patients with SLE take or fail to take their prescribed medications?

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Rheumatology Advance Access published online on January 16, 2009

Rheumatology, doi:10.1093/rheumatology/ken479

Why do patients with systemic lupus erythematosus take or fail to take

their prescribed medications? A qualitative study in a UK cohort

S. A. Chambers1, R. Raine2, A. Rahman1 and D. Isenberg1

1The Centre for Rheumatology, Department of Medicine

2Department of Epidemiology and Public Health, University College

London, London, UK

Abstract

Objective. It has been suggested that low adherence may contribute to

poor clinical outcomes in patients with SLE. In this study, we

explored the reasons why patients with lupus did or did not take their

medications as prescribed.

Methods. Questionnaires including a 10-cm visual analogue scale (VAS)

to assess self-reported adherence to prescribed medications were

distributed to 315 patients with SLE. The responses were used to

select a purposive sample of subjects who participated in interviews

to discuss why they did or did not take their medications.

Results. Of the 315 patients, 220 (70%) completed the questionnaire.

Thirty-three patients were interviewed. Themes explaining why patients

took their medications regularly included: the fear of worsening

disease, the belief that there was no effective therapeutic

alternative to their prescribed medications, lack of knowledge about

SLE to allow confidence in changing medications and feelings of moral

obligation or responsibility to others. Themes explaining why patients

did not take their medications regularly included: the belief that

lupus could and should be controlled using alternative methods, the

belief that long-term use of drugs was not necessary, the fear of drug

adverse effects, practical difficulties in obtaining medications, and

poor communication between patients and doctors.

Conclusion. The patients' reasons for taking or not taking their

medications largely related to previous experiences with the disease

and/or drugs. However, improvements in communication between doctors

and patients may promote better adherence in patients with SLE.

http://rheumatology.oxfordjournals.org/cgi/content/abstract/ken479v1?papetoc

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