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Best Pract Res Clin Rheumatol. 2013 Jun;27(3):329-40. doi: 10.1016/j.berh.2013.07.001.

Adherence to treatment in systemic lupus erythematosus patients.

Author information

1
Université René Descartes Paris V, 75005 Paris, France; AP-HP, Centre de référence maladies auto-immunes et systémiques rares, Service de médecine interne Pôle médecine, Hôpital Cochin, 27 rue du Faubourg Saint Jacques, 75679 Paris cedex 14, France. Electronic address: nathalie.costedoat@gmail.com.

Abstract

Adherence is defined as "the extent to which a person's behaviour coincides with medical or health advice." Poor adherence to therapeutic regimens is a common and expensive problem in patients with chronic diseases including systemic lupus erythematosus (SLE) and is associated with a higher risk of flares, morbidity, hospitalisations and poor renal outcome. Non-adherence to the treatment is multifactorial for most patients and varies according to unintentional or intentional patterns. The rates of non-adherence in SLE patients range from 3% to 76% depending on the assessment methods, which are all subject to limitations. Indeed, poor adherence to therapeutic regimens is difficult to evaluate. Two studies have shown that undetectable blood hydroxychloroquine (HCQ) concentration may be a simple, objective and reliable marker of non-adherence in SLE patients. The accurate diagnosis of non-adherence may prevent one from incorrectly interpreting disease manifestations as a lack of response. It may then avoid an unnecessary or even dangerous treatment escalation.

KEYWORDS:

Adherence; Compliance; Flare; Hydroxychloroquine; Systemic lupus erythematosus; Therapeutic drug monitoring

PMID:
24238690
DOI:
10.1016/j.berh.2013.07.001
[Indexed for MEDLINE]

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