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Abstract Number: 1128

Physician-Patient Interaction and Medication Adherence in Lupus Nephritis

Sofia Georgopoulou1, Louise Nel 2, Shirish Sangle 2 and David D'Cruz 3, 1King's College London & The Royal Marsden Hospital NHS Foundation Trust, London, England, United Kingdom, 2Guy's & St Thomas' Hospitals NHS Foundation Trust, London, England, United Kingdom, 3The Louise Coote Lupus Unit, Guy's Hospital, London, England, United Kingdom

Meeting: ACR/ARP Annual Meeting 2019

Keywords: , , ,

Session Information

Date: Monday, November 11, 2019

Title: Health Services Research Poster II – ACR/ARP

Session Type: Poster Session (Monday)

Session Time: 9:00AM-11:00AM

Background/Purpose: The quality of physician-patient interaction can have a significant impact on medication adherence. Little is known about this relationship in patients with lupus nephritis (LN).

Methods: Cross-sectional, quantitative study. Data collected included demographics, current medication, SLEDAI, medication adherence, beliefs about medicines, shared decision-making (SDM), patient-doctor depth of relationship (PDDR); patient-doctor quality of relationship (PRDQ9), interpersonal trust in a physician (ITP), and illness perceptions.

Results: 98 patients satisfying the American College of Rheumatology (ACR) classification criteria for LN completed the questionnaires. Binary logistic regression indicated that medication adherence was significantly predicted by: (a) ITP (B= 0.85; Wald= 3.94; 95%CI: 1.01, 5.44; p=0.05); (b) timeline cyclical (B= -0.89; Wald= 4.95; 95%CI: 0.19, 0.90 p< 0.05) and beliefs about necessity of medicines (B= 0.75; Wald= 4.14; 95%CI: 1.03, 4.38; p< 0.05). Mediation analysis showed that BMQ_N significantly mediated the relationship between trust and medication adherence when adjusted for age (B= 0.48, CI95%= 0.06, 1.08 p< 0.01). A further mediation analysis showed that PDDR (B= 0.05, CI95%= 0.01, 0.09 p< 0.001), SDM (B= 0.07, CI95%= 0.01, 0.13 p< 0.001) and PDRQ9 (B= 0.08, CI95%= 0.01, 0.16 p< 0.001) significantly mediated the relationship between illness coherence and ITP.

Conclusion: Findings highlighted two key elements: (a) the importance of patient trust in their physician in relation to medication adherence and (b) patients’ good understanding of their illness is linked to a better relationship with their doctor and greater participation in shared-decision making which is associated with increased trust. Tailored psycho-educational interventions could contribute to improving the quality of patient-doctor relationship, increase trust and SDM which, in turn, might improve medication adherence in patients with LN.

Disclosure: S. Georgopoulou, None; L. Nel, None; S. Sangle, None; D. D'Cruz, AstraZeneca, Bristol-Myers Squibb, 2, 5, Eli Lilly, Eli Lily, 2, 5, GlaxoSmithKline, 2, 5, Human Genome Sciences, 5, Idorsia, Merck Serono, 2, 5, Pfizer, Roche, 5, TEVA, 2, 5.

To cite this abstract in AMA style:

Georgopoulou S, Nel L, Sangle S, D'Cruz D. Physician-Patient Interaction and Medication Adherence in Lupus Nephritis [abstract]. Arthritis Rheumatol. 2019; 71 (suppl 10). https://acrabstracts.org/abstract/physician-patient-interaction-and-medication-adherence-in-lupus-nephritis/. Accessed .

ACR Meeting Abstracts - https://acrabstracts.org/abstract/physician-patient-interaction-and-medication-adherence-in-lupus-nephritis/