Systemic Lupus Erythematosus

Race May Play a Role in Medication Adherence in SLE

Approximately half of individuals with systemic lupus erythematosus (SLE) do not adhere to hydroxychloroquine therapy. However, according to a new study, understanding the differences in adherence between races and ethnicities can help tailor interventions and increase adherence.


To determine how to achieve more effective interventions among individuals with SLE taking hydroxychloroquine, the researchers measured the association of adherence with the World Health Organization’s 5 dimensions of adherence for chronic conditions: the patient’s socioeconomic status, as well as patient-, condition-, therapy-, and healthcare-system-related factors.


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The researchers analyzed data on 1956 participants who had visited Kaiser Permanente Northern California during 2006-2014. The participants were all aged 18 or older with SLE and had 2 or more consecutive prescriptions for hydroxychloroquine.


Successful adherence was defined as a medication possession ratio of at least 80%, an outcome that 58% of the participants met.


While socioeconomic factors did not predict adherence, increasing age (aged 65-89 years compared with ≤39 years), white race, and the number of rheumatology visits in the year before baseline were positively associated with adherence. 


The rheumatologist and medical center providing care were not associated with adherence.


“Qualitative research is needed to elucidate patient preferences for adherence support,” the researchers concluded.


—Colleen Murphy



Liu LHFevrier HBGoldfien RHemmerling A, Herrinton LJ. Understanding non-adherence with hydroxychloroquine therapy in systemic lupus erythematosus [published online February 1, 2019]. J Rheumatol.