Treatment adherence and disease burden of individuals with rheumatic diseases admitted as outpatients to a large rheumatology center in Shanghai, China.
Treatment adherence and disease burden of individuals with rheumatic diseases admitted as outpatients to a large rheumatology center in Shanghai, China.
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DOI：
10.2147/ppa.s144624
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发表时间：
2017
影响因子：
2.2
通讯作者：
Li T
中科院分区：
文献类型：
--
作者：
Zhang L;Lu GH;Ye S;Wu B;Shen Y;Li T
本研究的目的是确定中国风湿性疾病患者的治疗依从性和疾病负担，分析患者经历的详细用药问题，并确定与依从性相关的因素。招募确诊为强直性脊柱炎（AS）、类风湿性关节炎（RA）和系统性红斑狼疮（SLE）的患者，不考虑人口统计学、疾病严重程度和治疗特征。使用流变学依从性问卷和基于访谈的自我报告评估依从性。采用后向逐步多元回归分析确定与依从性相关的因素。我们收集了252名患有风湿性疾病并于2017年1月或2月访问我们门诊的患者的数据。SLE患者121例，RA患者70例，AS患者61例。总体依从率为41.7%，其中SLE患者为48.7%，RA患者为38.6%，AS患者为31.1%。总体EuroQol（EQ）指数为0.761; AS患者的EQ指数最高（0.792），其次是SLE（0.780）和RA（0.700）。SLE患者的年直接费用（5，103.58美元）也高于RA或AS患者。总体而言，我们的风湿病患者中有41.7%坚持治疗，低于世界上许多其他地区。这表明，重要的是要确定方法，提高这一人群的依从性。改善SLE患者的健康状况和减轻疾病负担尤为重要，SLE是我们分析的三种风湿性疾病中最常见的。我们的研究结果表明，提醒工具可以提高依从性。需要进一步的前瞻性研究来确认提醒工具和其他措施是否可以提高患者的依从性。
The purpose of this study was to determine treatment adherence and disease burden, analyze detailed medication problems experienced by patients, and identify factors associated with adherence in patients with rheumatic diseases in China. Patients with confirmed diagnoses of ankylosing spondylitis (AS), rheumatoid arthritis (RA), and systemic lupus erythematosus (SLE) were recruited, regardless of demographics, disease severity, and treatment characteristics. Adherence was assessed using the Compliance Questionnaire for Rheumatology and interview-based self-reports. A backwards-stepwise multivariate regression analysis was used to identify factors associated with adherence. We collected data on 252 patients who had a rheumatic disease and visited our outpatient clinic in January or February of 2017. There were 121 patients with SLE, 70 with RA, and 61 with AS. The overall adherence rate was 41.7%, with 48.7% for SLE patients, 38.6% for RA patients, and 31.1% for AS patients. The overall EuroQol (EQ)-index was 0.761; AS patients had the best EQ-index (0.792), followed by those with SLE (0.780) and RA (0.700). SLE patients also had greater annual direct costs (US$5,103.58) than RA or AS patients. Overall, 41.7% of our rheumatic disease patients were adherent to treatment, lower than in many other parts of the world. This indicates that it is important to identify methods that improve adherence in this population. It is particularly important to improve the health status and reduce the disease burden of patients with SLE, the most common of the three rheumatic diseases we analyzed. Our results suggest that reminder tools may improve adherence. Further prospective research is needed to confirm whether reminder tools and other measures can improve patient compliance.