Brijs Jan, Arat Seher, Westhovens Rene, Lenaerts Jan Leo, De Langhe Ellen
Faculty of Medicine, University Hospitals Leuven, KU Leuven, Belgium.
Department of Rheumatology, University Hospitals Leuven, KU Leuven, Belgium.
Musculoskeletal Care. 2019 Mar;17(1):44-53. doi: 10.1002/msc.1363. Epub 2018 Oct 9.
Treatment adherence is an important medical and pharmaco-economical phenomenon, influenced by multiple variables. Treatment adherence in systemic sclerosis (SSc) has been poorly studied.
The aim of the present study was to assess treatment adherence in SSc patients and to identify factors associated with good and poor adherence.
We conducted a monocentric, cross-sectional, observational study. Treatment adherence was evaluated by the Compliance Questionnaire of Rheumatology (CQR). The necessity of treatment and concerns about treatment were investigated using the Beliefs about Medicines Questionnaire-Specific (BMQ-S). The Illness Perception Questionnaire-Revised (IPQ-R) assessed illness perceptions. Disease-related characteristics were collected retrospectively.
A total of 66 patients were enrolled in this study. Of these, 47 (71.2%) had a weighted CQR score of ≤80% ("poor adherence") and 19 (28.8%) had a weighted CQR score of >80% ("good adherence"). No significant relationship between demographic, clinical or psychological factors and overall adherence could be found, except with the IPQ subscale "timeline acute/chronic" (p = 0.042). Our patient population estimated the necessity of their medication high (mean necessity score 20.5), with moderate concern beliefs (mean concern score 15.1). Subjective adherence, as self-reported by patients, was high.
This study demonstrated low treatment adherence rates in SSc patients. We could not identify demographic, clinical or psychological factors associated with treatment adherence, except with the IPQ subscale "timeline acute/chronic". This suggests a correlation between poor adherence and the belief that the disease will be chronic without improvement over time. Symptom relief was an important motivating factor for taking medication. The treatment necessity was scored higher than treatment concerns, but the necessity beliefs were not associated with adherence.
治疗依从性是一个重要的医学和药物经济学现象，受多种变量影响。系统性硬化症（SSc）的治疗依从性研究较少。
本研究旨在评估SSc患者的治疗依从性，并确定与依从性良好和不佳相关的因素。
我们进行了一项单中心、横断面、观察性研究。通过风湿病学依从性问卷（CQR）评估治疗依从性。使用特定药物信念问卷（BMQ-S）调查治疗的必要性和对治疗的担忧。修订后的疾病认知问卷（IPQ-R）评估疾病认知。回顾性收集疾病相关特征。
本研究共纳入66例患者。其中，47例（71.2%）的CQR加权评分≤80%（“依从性差”），19例（28.8%）的CQR加权评分>80%（“依从性好”）。除了与IPQ子量表“时间线急性/慢性”相关外（p = 0.042），未发现人口统计学、临床或心理因素与总体依从性之间存在显著关系。我们的患者群体认为他们的药物治疗必要性很高（平均必要性评分为20.5），担忧信念中等（平均担忧评分为15.1）。患者自我报告的主观依从性较高。
本研究表明SSc患者的治疗依从率较低。除了IPQ子量表“时间线急性/慢性”外，我们无法确定与治疗依从性相关的人口统计学、临床或心理因素。这表明依从性差与认为疾病将是慢性且不会随时间改善的信念之间存在相关性。症状缓解是服药的重要动机因素。治疗必要性得分高于治疗担忧，但必要性信念与依从性无关。
