Cincinnati Children's Hospital Medical Center, William Rowe Division of Rheumatology, MLC 4010, 3333 Burnet Avenue, Cincinnati, OH 45229-3039, USA.
J Rheumatol. 2012 Jan;39(1):174-9. doi: 10.3899/jrheum.110771. Epub 2011 Nov 15.
In a cohort of 70 patients with childhood-onset systemic lupus erythematosus (cSLE): to determine the baseline adherence to medications and visits; to investigate the effects of cellular text messaging reminders (CTMR) on adherence to clinic visits; and to study the influence of CTMR on adherence to use of hydroxychloroquine (HCQ).
CTMR were sent to 70 patients prior to clinic visits for 14 months. A subgroup of patients were evaluated for medication adherence to HCQ: 19 patients receiving CTMR prior to each scheduled HCQ dose were compared to 22 patients randomized to standard of care education about HCQ. Visit adherence was measured using administrative databases. Pharmacy refill information, self-report of adherence, and HCQ blood levels were utilized to monitor medication adherence to HCQ. Sufficient adherence to visits or HCQ was defined as estimates > 80%. Disease activity was primarily monitored with the Systemic Lupus Erythematosus Disease Activity Index.
At baseline, 32% of patients were sufficiently adherent to HCQ, and 81% to clinic visits. Visit adherence improved significantly by > 80% among those who were nonadherent to clinic visits at the baseline CTMR (p = 0.01). CTMR did not influence adherence to HCQ over time.
Patients with cSLE were only modestly adherent to HCQ and clinic visits. CTMR may be effective for improving visit adherence among adolescents and young adults with cSLE, but it does not improve adherence to HCQ.
在 70 例儿童发病系统性红斑狼疮（cSLE）患者队列中：确定基线时对药物和就诊的依从性；调查细胞文本消息提醒（CTMR）对就诊依从性的影响；并研究 CTMR 对羟氯喹（HCQ）使用依从性的影响。
在 14 个月的时间里，向 70 名患者在就诊前发送 CTMR。对一组患者进行了 HCQ 药物依从性评估：与接受每次预定 HCQ 剂量前 CTMR 的 19 名患者相比，22 名患者随机接受 HCQ 的标准护理教育，评估了他们对 HCQ 的药物依从性。通过行政数据库来衡量就诊依从性。通过药物补充信息、自我报告的依从性和 HCQ 血药浓度来监测对 HCQ 的药物依从性。足够的就诊或 HCQ 依从性定义为估计值>80%。主要使用系统性红斑狼疮疾病活动指数来监测疾病活动度。
在基线时，32%的患者对 HCQ 足够依从，81%的患者对就诊足够依从。在基线 CTMR 时不依从就诊的患者中，就诊依从性显著提高>80%（p=0.01）。随着时间的推移，CTMR 并没有影响 HCQ 的依从性。
患有 cSLE 的患者对 HCQ 和就诊的依从性仅为中等水平。CTMR 可能对改善青少年和年轻成人 cSLE 患者的就诊依从性有效，但不能改善 HCQ 的依从性。
