Sumary of Subpar lupus medication adherence among minorities may require ‘individualized approach’:
- Although cost, side effects and a busy schedule are among the most cited barriers to lupus treatment adherence in racial minorities, specific hurdles vary by patient and adherence level, requiring a personalized approach, according to data..
- “Even though we have known for a long time that medication adherence is suboptimal in patients with lupus, particularly underrepresented racial and ethnic minorities, barriers to medication adherence have not been well studied,”.
- “Existing qualitative studies to elucidate reasons for non-adherence have not specifically focused on racial and ethnic minorities or on those taking immunosuppressive medications, patients who are at highest risk of poor outcomes.”.
- Although cost, side effects and a busy schedule are among the most cited barriers to SLE treatment adherence in racial minorities, specific hurdles vary by patient and adherence level, requiring a personalized approach, according to data..
- “Additionally, most of the existing studies have only included patient but not clinician perspectives, and rarely included the use of conceptual models to facilitate understanding of the relationships among barriers and to inform intervention development,”.
- “Our study provides a more comprehensive understanding of adherence barriers and fills in some of these gaps in knowledge.”.
- To analyze the barriers to immunosuppressive adherence among racial minorities with SLE, Sun and colleagues conducted a qualitative descriptive study based on interviews with 24 individuals..
- Participants included 12 patients — four adherent and eight non-adherent — and 12 providers and staff at the Duke University Lupus Clinic..
- Interviewed providers included five physicians and two advanced practitioners, while interviewed staff included four nurses or medical assistants and one pharmacist..
- Interviews with patients lasted about 60 to 90 minutes and were conducted by a trained qualitative interviewer unaffiliated with the Duke lupus clinic, in a private conference room outside the clinic or over the phone..
- Patients were asked to describe barriers they experienced in obtaining and taking their immunosuppressive SLE medications, including factors that contributed to skipping or stopping their medications, and situations that make taking their medications more difficult..
- They were also prompted to comment on common barriers found in literature, including cost, lack of time, side effects, beliefs about medications and communication with providers, as well as how their disease makes them feel..
- Interviews with providers and staff lasted 30 to 45 minutes and were conducted by Sun, who is also a provider at the lupus clinic, either in a private area or over the phone..
- Providers were asked to describe their views on the adherence barriers faced by patients, including reasons they think patients do not follow prescription directions..
- According to the researchers, analysis of the interviews revealed three categories related to adherence barriers..
- barriers included external factors related to acquiring treatments, such as cost and pharmacy- and clinic-related issues..
- barriers included intrinsic factors, such as patients’ knowledge, beliefs and attitudes, as well as their physical and mental health..
- The most common barriers cited by patients were cost, side effects, a busy schedule or forgetting to take medication, and a lack of understanding, the researchers wrote….