Abstract

Background: In systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), due to their long term, multi-drug exposure and their side effects, non-adherence to therapy is common and is associated with adverse clinical outcome. In this study, we aimed to evaluate and compare medication adherence in patients with SLE and RA, considering their psychosocial factors, health literacy, and current life concerns.

Methods: 88 patients fulfilled the criteria of RA(N:46) and SLE(N:42);using disease-modifying antirheumatic drugs or immunosuppressive, we evaluated their demographic data, co-morbid diseases, the number of medications, estimated income, having health insurance, family size and disease poor prognostic factors. The 8-item Morisky’s Medication Adherence, Depression by Beck depression inventory (21 Q), and drug literacy level were used.

Results: Medication non-adherence was seen in 91.3% of the RA group and 90.4% of the SLE group. Moderate to very severe depression was seen in [21 (45.7%)] and [12 (25.9%)] of the RA and SLE patients, respectively. In the SLE group, depression and having poor prognostic factors, and in the RA group, depression, having co-morbid diseases, and higher pill numbers had a significant effect on medication adherence.

Conclusion: There was a high prevalence of drug non-adherence in our RA and SLE patients. The most prevalent factor in non-adherence in both groups was depression. After that, in RA patients the presence of co-morbid disease and in SLE patients, the presence of poor prognostic factors were related to non-adherence. Factors like income, health insurance, disease duration, and health literacy had no significant effect on medication adherence.

Keywords: RA, SLE, medication adherence, depression, health literacy, psychosocial factors.