Introduction Medication non-adherence is an important cause of treatment failure among patients with systemic lupus erythematosus (SLE). Depression is a common neuropsychiatric disorder associated with SLE. The aims of this study are to assess the prevalence of both medication non-adherence and depressed mood among Saudi patients with SLE by using validated tools and to explore the impact of both depressive symptoms and disease activity on medication non-adherence. Methods A cross-sectional study was conducted in outpatients with SLE. Medication non-adherence was assessed by using the Morisky Medication Adherence Scale, and the severity of depressed mood was evaluated with the Beck's Depression Inventory. Disease activity was measured using the SLE Disease Activity Index (SLEDAI). Multiple logistic regression models were used to identify the multivariate predictors of medication non-adherence. Results Out of 140 patients, 134 (95.7%) were females with a mean (±SD) age of 35.6 (±11.3) years and a disease duration of 8.8 (±6.7) years. Medication non-adherence and depressed mood were detected in 62.1% and 35% of the patients, respectively. A moderate or severe depressed mood was significantly associated with medication non-adherence ( p = 0.04). There was a significant correlation between disease activity and the severity of depressed mood ( r = 0.31, p = 0.003). Disease activity did not correlate with medication non-adherence. Logistic regression demonstrated that moderate-to-severe depressed mood increased the probability of medication non-adherence (OR 2.62; 1.02-6.71). Conclusion Medication non-adherence and depressive symptoms are highly prevalent among Saudi SLE patients. Routine screening could facilitate the early detection and management of depression and medication adherence.
Background Multiple sclerosis (MS) is the most common disabling neurological disease in young adults worldwide with majority of patients manifest symptoms between 20 and 40 years of age. The aims of this study are to explore physicians’ perspectives, views, and behaviors in diagnosing and treating patients with MS in Saudi Arabia and investigate the prescribing pattern of disease-modifying therapies (DMTs). Methods A sequential explanatory mixed-method approach was used to achieve the study objectives. The quantitative arm of the study consisted of patient data extracted from the Saudi MS registry from 2015 to 2018. The qualitative study consisted of in-depth semi-structured interviews with physicians using a validated interview topic guide comprising 28 open-ended questions. Results We extracted data of 2,507 patients from 20 different hospitals across Saudi Arabia. Patients’ mean age was 34 ± 10 years; two-thirds (n = 1,668) were female. 92% (n = 2,292) had relapsing-remitting multiple sclerosis, and 5% (n = 126) had secondary-progressive multiple sclerosis. In general, patients with MS received at least one drug as the DMT or DMTs and corticosteroids for those with relapse. Qualitatively, nine physicians agreed to participate in the interviews. Of them, five (55%) were male and four were female from different regions. Thematic analysis yielded three main themes: practice, views, and challenges. Conclusions The prevalence of MS in Saudi Arabia is raising but is still much lower than that reported in the Gulf region. A national MS guideline is needed to streamline diagnosis and treatment criteria, avoid any delay in treatment, and guide physicians who provide care for patients with MS.
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