Pilot Intervention to Improve Medication Adherence Among Patients With Systemic Lupus Erythematosus Using Pharmacy Refill Data.

dc.contributor.author

Sun, Kai

dc.contributor.author

Eudy, Amanda M

dc.contributor.author

Rogers, Jennifer L

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Criscione-Schreiber, Lisa G

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Sadun, Rebecca E

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Doss, Jayanth

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Maheswaranathan, Mithu

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Barr, Ann Cameron

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Eder, Lena

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Corneli, Amy L

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Bosworth, Hayden B

dc.contributor.author

Clowse, Megan EB

dc.date.accessioned

2023-11-12T17:27:48Z

dc.date.available

2023-11-12T17:27:48Z

dc.date.issued

2023-03

dc.date.updated

2023-11-12T17:27:47Z

dc.description.abstract

Objective

Despite high rates of medication nonadherence among patients with systemic lupus erythematosus (SLE), effective interventions to improve adherence in SLE are limited. We aimed to assess the feasibility of a pilot intervention and explore its effect on adherence.

Methods

The intervention used pharmacy refill data to monitor nonadherence and prompt discussions surrounding SLE medications during clinic encounters. Over 12 weeks, the intervention was delivered through routine clinic visits by providers to patients with SLE who take SLE-specific medications. We measured acceptability, appropriateness, and feasibility using provider surveys. We also measured acceptability by patient surveys and feasibility by medical record documentation. We explored change in adherence by comparing percent of patients with medication possession ratio (MPR) ≥80% 3 months before and after the intervention visit using the McNemar's test.

Results

Six rheumatologists participated; 130 patients were included in the analysis (median age 43, 95% female, and 59% racial and ethnic minorities). Implementation of the intervention was documented in 89% of clinic notes. Provider surveys showed high scores for feasibility (4.7/5), acceptability (4.4/5), and appropriateness (4.6/5). Among patient surveys, the most common reactions to the intervention visit were feeling determined (32%), empowered (32%), and proud (19%). Proportion of patients with MPR ≥80% increased from 48% to 58% (P = 0.03) after the intervention visit.

Conclusion

Our intervention showed feasibility, acceptability, and appropriateness and led to a statistically significant improvement in adherence. Future work should refine the intervention, assess its efficacy in a controlled setting, and adapt its use among other clinic settings.
dc.identifier.issn

2151-464X

dc.identifier.issn

2151-4658

dc.identifier.uri

https://hdl.handle.net/10161/29368

dc.language

eng

dc.publisher

Wiley

dc.relation.ispartof

Arthritis care & research

dc.relation.isversionof

10.1002/acr.24806

dc.subject

Humans

dc.subject

Lupus Erythematosus, Systemic

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Ambulatory Care

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Pilot Projects

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Pharmacy

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Adult

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Female

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Male

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Medication Adherence

dc.title

Pilot Intervention to Improve Medication Adherence Among Patients With Systemic Lupus Erythematosus Using Pharmacy Refill Data.

dc.type

Journal article

duke.contributor.orcid

Sun, Kai|0000-0002-8406-2932

duke.contributor.orcid

Eudy, Amanda M|0000-0002-3107-5545

duke.contributor.orcid

Sadun, Rebecca E|0000-0001-7768-3565

duke.contributor.orcid

Maheswaranathan, Mithu|0000-0003-0866-0022

duke.contributor.orcid

Corneli, Amy L|0000-0002-4629-4329

duke.contributor.orcid

Bosworth, Hayden B|0000-0001-6188-9825

duke.contributor.orcid

Clowse, Megan EB|0000-0002-8579-3470

pubs.begin-page

550

pubs.end-page

558

pubs.issue

3

pubs.organisational-group

Duke

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School of Medicine

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Basic Science Departments

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Clinical Science Departments

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Institutes and Centers

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Medicine

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Pediatrics

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Psychiatry & Behavioral Sciences

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Medicine, General Internal Medicine

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Medicine, Rheumatology and Immunology

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Pediatrics, Rheumatology

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Duke Cancer Institute

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Duke Clinical Research Institute

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Institutes and Provost's Academic Units

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University Institutes and Centers

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Duke Global Health Institute

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Center for the Study of Aging and Human Development

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Initiatives

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Duke Science & Society

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Population Health Sciences

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Duke Innovation & Entrepreneurship

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Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences

pubs.organisational-group

Duke - Margolis Center For Health Policy

pubs.publication-status

Published

pubs.volume

75

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