Medical adherence in patients with systemic lupus erythematosus in Germany: predictors and reasons for non-adherence - a cross-sectional analysis of the LuLa-cohort
Medical adherence in patients with systemic lupus erythematosus in Germany: predictors and reasons for non-adherence - a cross-sectional analysis of the LuLa-cohort
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DOI：
10.1177/0961203318785245
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发表时间：
2018-09-01
期刊：
影响因子：
2.6
通讯作者：
Schneider, M.
中科院分区：
文献类型：
--
作者：
Chehab, G.;Sauer, G. M.;Schneider, M.
目的药物治疗依从性对治疗控制和成功有重要影响，尤其是在慢性疾病中，但往往未被认识到。除了临床，社会经济，疾病相关和治疗相关的参数，一般和个人的健康信念，以及对健康的看法，可以影响依从性。我们的目的是调查坚持狼疮特异性药物治疗的德国狼疮患者和评估的影响因素，包括有害或有益的健康观念和believs.Methods红斑狼疮（LE）的长期研究（LuLa研究）是一个全国性的纵向研究，德国白人系统性红斑狼疮患者谁已经评估，自2001年以来，每年使用自我报告的问卷调查。2013年，我们纳入了关于医疗依从性（Morisky药物依从性量表; MMAS-4）、处方药物信念（BMQ）、疾病感知和患者健康控制点（HLC）的问题。我们提出了一个横截面分析，以评估预测因素的坚持使用多变量逐步logistic regression.Results五七九例参加，其中81人没有采取任何狼疮特异性药物治疗，其中40人没有完成MMAS-4，因此被省略。只有62.7%的人报告了高依从性。低医疗依从性的非故意行为远远超过故意行为。使用硫唑嘌呤（OR：1.85; 95% CI：1.02-3.34）、泼尼松
Objective Adherence to medication has a major impact on treatment control and success especially in chronic diseases but often remains unrecognized. Besides clinical, socioeconomic, disease-related and treatment-related parameters, general and personal health beliefs, as well as perception of health, can affect adherence. Our aim was to investigate the adherence to lupus-specific medications in German lupus patients and to assess influencing factors including detrimental or beneficial effects of health perceptions and beliefs.Methods The Lupus Erythematosus (LE) Long-Term Study (LuLa-study) is a nationwide longitudinal study among German Caucasian patients with systemic lupus erythematosus who have been assessed annually using a self-reported questionnaire since 2001. In 2013, we included questions concerning medical adherence (Morisky Medication Adherence Scale; MMAS-4), beliefs about medication prescribed (BMQ), illness perception and about the patients' health locus of control (HLC). We present a cross-sectional analysis to assess predictors of adherence using a multivariable stepwise logistic regression.Results Five hundred and seventy-nine patients participated, 81 of whom did not take any lupus-specific medication and 40 of whom did not complete the MMAS-4 and were therefore omitted. Only 62.7% reported high adherence. Unintentional behaviour for low medical adherence exceeded the intentional behaviour by far. The use of azathioprine (OR: 1.85; 95% CI: 1.02-3.34), prednisone