Department of Medicine, Albany Medical Center, Albany, NY, USA.
Division of Pulmonary and Critical Care Medicine, Albany Medical College, MC-91, Albany, NY, 12208, USA.
Lung. 2024 Dec;202(6):785-792. doi: 10.1007/s00408-024-00746-7. Epub 2024 Sep 23.
We measured corticosteroid medication adherence (CMA) in sarcoidosis patients and analyzed if demographic and clinical factors, beliefs about medications, corticosteroid side-effects, psychosocial status, and the doctor-patient relationship were associated with corticosteroid adherence.
Sarcoidosis patients receiving corticosteroids were eligible to participate. CMA was measured using the Medication Adherence Response Scale-10 (MARS-10), a validated patient reported outcome measure (PRO). Data collection included patient demographics and clinical variables to assess their sarcoidosis phenotype. The patients were administered additional PROs concerning their psychosocial status, beliefs about medication use, corticosteroid side-effects and the strength of their doctor-patient relationship.
132 patients were enrolled. Their mean prednisone dose was 9.9 ± 7.5 mg/day. 75% (99/132) were adherent with corticosteroids (MARS-10 ≥ 6) and 25% (33/132) were nonadherent (MARS-10 < 6). All demographic features, education level, and annual family income were not associated with CMA. Most clinical variables including spirometry, use of additional sarcoidosis drugs, number of organs involved with sarcoidosis were not associated with CMA. Almost all PROs including a better attitude toward medication use, less psychological issues, less corticosteroid side-effects, and a stronger doctor-patient relationship were associated with better CMA. A multi-logistic regression found that patient-doctor communication and the patient's intrinsic beliefs about the use of medications remained associated with CMA.
We found no significant relationship between demographic or socioeconomic factors and CMA. Few clinical factors were associated with CMA. In a univariate analysis, CMA was associated with physician-doctor communication, beliefs about medication use, psychological/emotional issues, and corticosteroid side-effects. Only the first two of these factors remained associated with CMA in a multi-logistic analysis. These data suggest that CMA is heavily influenced by sarcoidosis patient beliefs about medications, and less so by patient demographics.
我们测量了结节病患者的皮质类固醇药物依从性（CMA），并分析了人口统计学和临床因素、对药物的信念、皮质类固醇副作用、心理社会状况和医患关系是否与皮质类固醇依从性相关。
接受皮质类固醇治疗的结节病患者有资格参加。使用经过验证的患者报告结局测量（PRO）药物依从性反应量表-10（MARS-10）测量 CMA。数据收集包括患者的人口统计学和临床变量，以评估他们的结节病表型。患者还接受了关于其心理社会状况、对药物使用的信念、皮质类固醇副作用以及医患关系强度的其他 PRO 评估。
共纳入 132 名患者。他们的平均泼尼松剂量为 9.9±7.5mg/天。75%（99/132）的患者对皮质类固醇药物依从性较好（MARS-10≥6），25%（33/132）的患者不依从（MARS-10<6）。所有人口统计学特征、教育程度和家庭年收入与 CMA 无关。大多数临床变量，包括肺功能、使用其他结节病药物、受累器官数量与 CMA 无关。几乎所有 PRO，包括对药物使用的态度更好、心理问题更少、皮质类固醇副作用更少、医患关系更强，都与更好的 CMA 相关。多逻辑回归发现，医患沟通和患者对药物使用的内在信念与 CMA 仍然相关。
我们没有发现人口统计学或社会经济因素与 CMA 之间存在显著关系。很少有临床因素与 CMA 相关。在单变量分析中，CMA 与医生-患者沟通、对药物使用的信念、心理/情绪问题和皮质类固醇副作用相关。在多逻辑回归分析中，只有前两个因素与 CMA 相关。这些数据表明，CMA 受结节病患者对药物的信念影响较大，而受患者人口统计学特征的影响较小。
