Pilot Intervention to Improve Medication Adherence among Patients with Systemic Lupus Erythematosus Using Pharmacy Refill Data.

Journal Article (Journal Article)

OBJECTIVE: Despite high rates of medication non-adherence among patients with systemic lupus erythematosus (SLE), effective interventions to improve adherence in SLE are limited. We aimed to assess the feasibility of a pilot intervention and explore its effect on adherence (clinicaltrials.gov identifier NCT03738826). METHODS: The intervention used pharmacy refill data to monitor non-adherence and prompt discussions surrounding SLE medications during clinic encounters. Over 12 weeks, the intervention was delivered through routine clinic visits by providers to patients with SLE who take SLE-specific medications. We measured acceptability, appropriateness, and feasibility using provider surveys. We also measured acceptability by patient surveys and feasibility by medical record documentation. We explored change in adherence by comparing percent of patients with medication possession ratio (MPR) ≥80% three months before and after the intervention visit using the McNemar's test. RESULTS: Six rheumatologists participated; 130 patients were included in the analysis (median age 43, 95% female, and 59% racial-ethnic minorities). Implementation of the intervention was documented in 89% of clinic notes. Provider surveys showed high scores for feasibility (4.7/5), acceptability (4.4/5), and appropriateness (4.6/5). Among patient surveys, the most common reactions to the intervention visit were feeling determined (32%), empowered (32%), and proud (19%). Proportion of patients with MPR ≥80% increased from 48% to 58% (p=0.03) after the intervention visit. CONCLUSION: Our intervention showed feasibility, acceptability, and appropriateness, and led to a statistically significant improvement in adherence. Future work should refine the intervention, assess its efficacy in a controlled setting, and adapt its use among other clinic settings. This article is protected by copyright. All rights reserved.

Full Text

Duke Authors

Cited Authors

  • Sun, K; Eudy, AM; Rogers, JL; Criscione-Schreiber, LG; Sadun, RE; Doss, J; Maheswaranathan, M; Barr, AC; Eder, L; Corneli, AL; Bosworth, HB; Clowse, MEB

Published Date

  • November 5, 2021

Published In

PubMed ID

  • 34739191

Pubmed Central ID

  • PMC9068832

Electronic International Standard Serial Number (EISSN)

  • 2151-4658

Digital Object Identifier (DOI)

  • 10.1002/acr.24806

Language

  • eng

Conference Location

  • United States