Adherence to treatment in systemic lupus erythematosus patients

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• 作者：Nathalie Costedoat-Chalumeau ; Jacques Pouchot ; Ga毛lle Guettrot-Imbert ; V茅ronique Le Guern ; Ga毛lle Leroux ; Donata Marra ; Nathalie Morel ; Jean-Charles Piette
• 关键词：Hydroxychloroquine ; Systemic lupus erythematosus ; Compliance ; Adherence ; Flare ; Therapeutic drug monitoring
• 刊名：Best Practice Research Clinical Rheumatology
• 出版年：June, 2013
• 年：2013
• 卷：27
• 期：3
• 页码：329-340
• 全文大小：246 K

文摘

Adherence is defined as 鈥渢he extent to which a person's behaviour coincides with medical or health advice.鈥?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.