Systemic lupus erythematosus in three ethnic groups. XVIII. Factors predictive of poor compliance with study visits

Abstract

Objective. To determine the baseline factors predictive of poor compliance with study visits in a longitudinal multiethnic lupus cohort study. Methods. Patients with systemic lupus erythematosus (n ‫؍‬ 344) representing a total of 2,069 potential study visits were studied. Of the participants, 24.4% were Hispanic, 43.3% African American, and 32.3% Caucasian. Noncompliance was defined as missing 2 or more study visits. For the purpose of these analyses, visits completed only by review of medical records were considered missing. Baseline socioeconomic-demographic, clinical, and psychosocial features between compliant and noncompliant patients were compared. Variables with P < 0.10 were then entered into a multivariable logistic regression analysis with compliance being the dependent variable.Results. There were 178 compliant and 166 noncompliant patients. Noncompliant patients were more likely to be young, unmarried, of African American ethnicity, live closer to the medical centers, and have longer disease duration and greater disease activity as assessed by the physician than the compliant patients. In the multivariable model, longer disease duration (P ‫؍‬ 0.010), higher level of disease activity (P ‫؍‬ 0.009), and shorter distance to travel to study visits (P ‫؍‬ 0.046) were predictors of noncompliance; their odds ratios and confidence intervals were below 1. Conclusions. We have identified baseline patient characteristics that may predict noncompliance with study visits (disease duration, disease activity, and distance to the medical center). This information will serve as the basis for developing interventions to curtail noncompliance. Our data may have applicability in other lupus cohort studies.

Європейські Доказові Рекомендації По Діагностиці Та Лікуванню Люпус-Нефриту У Дітей: Ініціатива SHARE

“…Lack of adherence to therapy can be as high as 50%, and has been associated with higher persistent disease activity and poorer renal outcomes (70)(71)(72)(73). In addition, the aim of LN treatment is complete renal response but RCT in adult LN have shown that time is needed to reach this response and can be awaited for at least 3-6 months after start of treatment (43).…”

Psychiatric Illness of Systemic Lupus Erythematosus in Childhood: Spectrum of Clinically Important Manifestations

“…Низкая приверженность терапии у пациентов под-росткового возраста ассоциируется с персистированием более высоких показателей активности и формированием большего ущерба от болезни при сравнительно небольшой продолжительности заболевания [86][87][88]. По данным ли-тературы, комплаенс в этой возрастной группе может соот-ветствовать 50%, при этом тяжесть течения заболевания и частота обострений не гарантируют приверженности ле-чению [89].…”

Epidemiology of systemic lupus erythematosus at the change of the millennium: lessons from the Euro-Lupus and the LUMINA projects

“…In contrast to the 'Euro-Lupus' project, the authors of the LUMINA study have split their data into more than 30 partial analyses, describing many diverse aspects such as the early clinical manifestations, 13 the effect of genetic, socio-economic and ethnic factors on disease onset, 14 the influence of poverty and wealth, the predictors of disease activity 15 and of early mortality, 16 or the factors predictive of poor compliance with study visits. 17 The current issue of Lupus publishes three additional original articles from this project, analysing the factors associated with patients being lost to follow-up, 18 the contribution of admixture and socio-economic status to renal involvement, 19 and the factors predictive of a decline to low levels of disease activity. 20 A characteristic of the LUMINA project is the multiethnic nature of its cohort.…”