Barriers to treatment adherence among African American and white women with systemic lupus erythematosus
Barriers to treatment adherence among African American and white women with systemic lupus erythematosus
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DOI：
10.1002/art.10790
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发表时间：
2002-12-15
期刊：
影响因子：
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通讯作者：
Guice, D
中科院分区：
文献类型：
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作者：
Mosley-Williams, A;Lumley, MA;Guice, D
目标。确定患有系统性红斑狼疮(SLE)的非裔美国人的治疗依从性是否比白人差，并确定种族差异对依从性的障碍，以及障碍如何影响依从性。我们比较了68名非洲裔美国人和54名白人SLE女性在19个潜在障碍、过去一年中的两个坚持行为以及这些潜在障碍与每个不坚持行为之间的关系。非洲裔美国人和白人在大多数障碍上是相似的，尽管非洲裔美国人更有可能依赖宗教，也更担心长期药物治疗的影响。这两个民族在不遵守药物治疗方面具有可比性，但白人往往比非裔美国人更不遵守诊所预约。最后，我们发现障碍与负面情绪(抑郁、药物治疗)有关。担忧、身体症状)以及短期记忆问题和需要儿童或老年人护理与非裔美国人不遵守承诺有关，而被认为是。治疗无效和对医生缺乏信任与白人不坚持治疗有关。依从性障碍和不依从性之间的关系可能是种族特有的，这表明解决障碍的干预措施应该针对特定的群体。
Objective. To determine whether African Americans with systemic lupus erythematosus (SLE) have poorer treatment adherence than whites, and to determine ethnic group differences in barriers to adherence, and how barriers affect adherence.Methods. We compared 68 African American and 54 white women with SLE on 19 potential barriers, on 2 adherence behaviors during the past year, and on how the potential barriers relate to each nonadherence behavior.Results. African Americans and whites were similar on most barriers, although African Americans were more likely to rely on religion and were more concerned about long-term medication effects. The 2 ethnic groups were comparable on medication nonadherence, but whites tended to have poorer clinic appointment adherence than African Americans. Finally, we found that barriers related to negative affect (depression, medication. concerns, physical symptoms) as well as short-term memory problems and the need for child or elder care were associated with nonadherence among African Americans, whereas perceived. treatment inefficacy and lacking trust in physicians were associated with nonadherence among whites.Conclusion. Relationships between adherence barriers and nonadherence may be ethnicity specific, suggesting that interventions to address barriers should be targeted to specific groups.