Medication adherence is influenced by resilience in patients with systemic lupus erythematosus

Lupus. 2021 Jun;30(7):1051-1057. doi: 10.1177/09612033211004722. Epub 2021 Apr 1.

Abstract

Objective: Evidence on the relationship between resilience and medication adherence in systemic lupus erythematosus (SLE) patients is lacking. We aimed to examine the impact of resilience on medication adherence in SLE patients.

Method: In a cross-sectional analysis SLE outpatients were assessed for resilience (Connor-Davison Resilience Scale, CD-RISC), depressive symptoms (CES-D) and medication adherence (Compliance Questionnaire for Rheumatology [CQR]). The disease activity index (mexSLEDAI) and damage (SLICC Damage Index) were administered. Factors independently associated with adherence were identified using multivariate logistic regression.

Results: Of the 157 patients, 152 (96.8%) were female with a median age of 45.9 (IQR: 39.0-55.5) years and disease duration of 14 (IQR: 10.0-19.0) years. Medication adherence (CQR ≥80%) and depressive symptoms were found in 74.5% and 43.9% of patients, respectively. Adherent patients had a lower CES-D score and a higher CD-RISC score. In the multivariate analysis adjusting for demographic and clinical confounders, resilience and older age protected against non-adherence (OR 0.96, [95% CI 0.94-0.99] and OR 0.96 [95% CI 0.93-0.98], respectively).

Conclusion: In SLE patients, resilience and older age, which possibly associated with better medication adherence, may protect against non-adherence.

Keywords: Systemic lupus erythematosus; adherence; depression; resilience.

MeSH terms

  • Adult
  • Case-Control Studies
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology*
  • Female
  • Humans
  • Logistic Models
  • Lupus Erythematosus, Systemic / drug therapy
  • Lupus Erythematosus, Systemic / psychology*
  • Male
  • Medication Adherence / psychology*
  • Medication Adherence / statistics & numerical data
  • Mexico / epidemiology
  • Middle Aged
  • Multivariate Analysis
  • Resilience, Psychological
  • Severity of Illness Index
  • Surveys and Questionnaires