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Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications.

Publication ,  Conference
Barr, AC; Clowse, M; Maheswaranathan, M; Eder, L; Eudy, AM; Criscione-Schreiber, LG; Rogers, JL; Sadun, RE; Doss, J; Sun, K
Published in: Arthritis Care Res (Hoboken)
January 2023

OBJECTIVE: Medication nonadherence is common among patients with systemic lupus erythematosus (SLE), and adherence often fluctuates with time. Underrepresented racial minorities have disproportionately lower rates of medication adherence and more severe SLE manifestations. We aimed to identify modifiable factors associated with persistent medication nonadherence. METHODS: Patients taking ≥1 SLE medication were enrolled. Adherence data were obtained at baseline and at follow-up roughly 1 year later using both self-reported adherence and pharmacy refill data. Covariates included patient-provider interaction, patient self-efficacy, and clinical factors. We compared characteristics of patients in 3 groups using the Kruskal-Wallis H test: persistent nonadherence (low adherence by self-report and refill rates at both time points); persistent adherence (high adherence by self-report and refill rates at both time points); and inconsistent adherence (the remainder). RESULTS: Among 77 patients (median age 44 years, 53% Black, 96% female), 48% had persistent nonadherence. Compared with other adherence groups, patients with persistent nonadherence were younger and more likely to be Black, have lower income, take ≥2 SLE medications, have higher SLE-related damage at baseline, and have higher physician global assessment of disease activity at follow-up. Persistently nonadherent patients also rated more hurried communication with providers (particularly fast speech and difficult word choice) and had lower self-efficacy in managing medications. CONCLUSION: Potential avenues to improve medication adherence include optimizing patient-provider communication, specifically avoiding difficult vocabulary and fast speech, and enhancing patient self-efficacy, particularly among younger Black patients with lower income who are at higher risk for nonadherence.

Duke Scholars

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Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

January 2023

Volume

75

Issue

1

Start / End Page

69 / 75

Location

United States

Related Subject Headings

  • Self Report
  • Self Efficacy
  • Medication Adherence
  • Male
  • Lupus Erythematosus, Systemic
  • Humans
  • Female
  • Communication
  • Adult
  • 4201 Allied health and rehabilitation science
 

Citation

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MLA
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Barr, A. C., Clowse, M., Maheswaranathan, M., Eder, L., Eudy, A. M., Criscione-Schreiber, L. G., … Sun, K. (2023). Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications. In Arthritis Care Res (Hoboken) (Vol. 75, pp. 69–75). United States. https://doi.org/10.1002/acr.25030
Barr, Ann Cameron, Megan Clowse, Mithu Maheswaranathan, Lena Eder, Amanda M. Eudy, Lisa G. Criscione-Schreiber, Jennifer L. Rogers, Rebecca E. Sadun, Jayanth Doss, and Kai Sun. “Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications.” In Arthritis Care Res (Hoboken), 75:69–75, 2023. https://doi.org/10.1002/acr.25030.
Barr AC, Clowse M, Maheswaranathan M, Eder L, Eudy AM, Criscione-Schreiber LG, et al. Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications. In: Arthritis Care Res (Hoboken). 2023. p. 69–75.
Barr, Ann Cameron, et al. “Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications.Arthritis Care Res (Hoboken), vol. 75, no. 1, 2023, pp. 69–75. Pubmed, doi:10.1002/acr.25030.
Barr AC, Clowse M, Maheswaranathan M, Eder L, Eudy AM, Criscione-Schreiber LG, Rogers JL, Sadun RE, Doss J, Sun K. Association of Hurried Communication and Low Patient Self-Efficacy With Persistent Nonadherence to Lupus Medications. Arthritis Care Res (Hoboken). 2023. p. 69–75.
Journal cover image

Published In

Arthritis Care Res (Hoboken)

DOI

EISSN

2151-4658

Publication Date

January 2023

Volume

75

Issue

1

Start / End Page

69 / 75

Location

United States

Related Subject Headings

  • Self Report
  • Self Efficacy
  • Medication Adherence
  • Male
  • Lupus Erythematosus, Systemic
  • Humans
  • Female
  • Communication
  • Adult
  • 4201 Allied health and rehabilitation science