Background/Purpose: Systemic Lupus Erythematosus (SLE) is a chronic and complex autoimmune disease that requires adequate treatment adherence to control disease activity and prevent complications. However, adherence rates among SLE patients are generally low, influenced by multiple personal, social, and clinical factors. This study aims to evaluate adherence to oral pharmacological treatment in SLE patients, analyze factors associated with therapeutic compliance, and identify patient profiles with low adherence levels.

Methods: This was an observational, cross-sectional, analytical study conducted on a cohort of 115 SLE patients followed at the Rheumatology outpatient clinic of a tertiary hospital in northern Spain. Adherence to oral treatment was assessed using the Compliance Questionnaire on Rheumatology (CQR), a validated tool for evaluating therapeutic adherence in rheumatologic diseases. Good adherence was defined as a CQR score ≥ 80. Statistical analysis included descriptive statistics and Chi-square tests to identify significant associations between adherence and the studied variables.

Results: Among 115 SLE patients, 105 were women (91.30%), with a mean age of 53.35 ± 14.27 years and an average disease duration of 14.27 ± 14 years. Sociodemographic and clinical factors influencing adherence were analyzed (Table 1), identifying risk profiles with lower compliance. Overall adherence was suboptimal, with only 58.26% achieving a CQR score ≥ 80. Women had higher adherence (73.33%) than men (60.0%). University-educated patients adhered better (81.48%) than those with primary education (50.0%). Married individuals showed the highest adherence (75.36%), while divorced and widowed patients had the lowest (50.0% and 25.0%, respectively). Employment favored adherence (80.0%), surpassing unemployed or retired patients (65.0%). Patients without comorbidities adhered better (81.25%) than those with comorbidities (70.71%). Medication burden influenced adherence, with higher rates in those taking one (75.34%) or two drugs (71.43%) compared to those on three or more. Significant associations were found between adherence and sex (p = 0.0278), education (p = 0.0439), employment (p = 0.0316), and comorbidities (p = 0.0402). Marital status (p = 0.0944) and medication count (p = 0.2959) showed no significant correlation. Low adherence profiles included male sex, lower education, unemployment, comorbidities, and divorced/widowed marital status.

Conclusion: This study highlights the low treatment adherence rates among SLE patients, driven by sociodemographic and clinical factors. Findings emphasize the need for targeted interventions in vulnerable subgroups, including men, individuals with lower educational attainment, unemployed patients, and those with comorbidities.

Table 1. Characteristics of the sample (n = 115), variables studied, and statistical analysis results.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/evaluation-of-oral-treatment-adherence-in-systemic-lupus-erythematosus-patients-indentification-of-risks-profiles/