A qualitative study of facilitators of medication adherence in systemic lupus erythematosus: Perspectives from rheumatology providers/staff and patients.
| dc.contributor.author | Herndon, Shannon | |
| dc.contributor.author | Corneli, Amy | |
| dc.contributor.author | Dombeck, Carrie | |
| dc.contributor.author | Swezey, Teresa | |
| dc.contributor.author | Clowse, Megan Eb | |
| dc.contributor.author | Rogers, Jennifer L | |
| dc.contributor.author | Criscione-Schreiber, Lisa G | |
| dc.contributor.author | Sadun, Rebecca E | |
| dc.contributor.author | Doss, Jayanth | |
| dc.contributor.author | Eudy, Amanda M | |
| dc.contributor.author | Bosworth, Hayden B | |
| dc.contributor.author | Sun, Kai | |
| dc.date.accessioned | 2024-01-25T15:54:38Z | |
| dc.date.available | 2024-01-25T15:54:38Z | |
| dc.date.issued | 2024-01 | |
| dc.description.abstract | ObjectiveSystemic lupus erythematosus (SLE) disproportionately affects patients from racial and ethnic minority groups. Medication adherence is lower among these patient populations, and nonadherence is associated with worse health outcomes. We aimed to identify factors that enable adherence to immunosuppressive medications among patients with SLE from racial and ethnic minority groups.MethodsUsing a qualitative descriptive study design, we conducted in-depth interviews with purposefully selected (1) patients with SLE from racial and ethnic minority groups who were taking immunosuppressants and (2) lupus providers and staff. We focused on adherence facilitators, asking patients to describe approaches supporting adherence and for overcoming common adherence challenges and providers and staff to describe actions they can take to foster patient adherence. We used applied thematic analysis and categorized themes using the Capability, Opportunity, Motivation, Behavior (COM-B) model.ResultsWe interviewed 12 patients (4 adherent and 8 nonadherent based on medication possession ratio) and 12 providers and staff. Although each patient described a unique set of facilitators, patients most often described social support, physical well-being, reminders, and ability to acquire medications as facilitators. Providers also commonly mentioned reminders and easy medication access as facilitators as well as patient education/communication and empowerment.ConclusionUsing an established behavioral change model, we categorized a breadth of adherence facilitators within each domain of the COM-B model while highlighting patients' individual approaches. Our findings suggest that an optimal adherence intervention may require a multi-modal and individually tailored approach including components from each behavioral domain-ensuring medication access (Capability) and utilizing reminders and social support (Opportunity), while coupled with internal motivation through improved communication and empowerment (Motivation). | |
| dc.identifier.issn | 0961-2033 | |
| dc.identifier.issn | 1477-0962 | |
| dc.identifier.uri | ||
| dc.language | eng | |
| dc.publisher | SAGE Publications | |
| dc.relation.ispartof | Lupus | |
| dc.relation.isversionof | 10.1177/09612033231225843 | |
| dc.rights.uri | ||
| dc.subject | Systemic lupus erythematosus | |
| dc.subject | behavior | |
| dc.subject | healthcare disparities | |
| dc.subject | immunosuppressive agents | |
| dc.subject | medication adherence | |
| dc.subject | qualitative research | |
| dc.title | A qualitative study of facilitators of medication adherence in systemic lupus erythematosus: Perspectives from rheumatology providers/staff and patients. | |
| dc.type | Journal article | |
| duke.contributor.orcid | Corneli, Amy|0000-0002-4629-4329 | |
| duke.contributor.orcid | Clowse, Megan Eb|0000-0002-8579-3470 | |
| duke.contributor.orcid | Sadun, Rebecca E|0000-0001-7768-3565 | |
| duke.contributor.orcid | Eudy, Amanda M|0000-0002-3107-5545 | |
| duke.contributor.orcid | Bosworth, Hayden B|0000-0001-6188-9825 | |
| duke.contributor.orcid | Sun, Kai|0000-0002-8406-2932 | |
| pubs.begin-page | 9612033231225843 | |
| pubs.organisational-group | Duke | |
| pubs.organisational-group | School of Medicine | |
| pubs.organisational-group | Basic Science Departments | |
| pubs.organisational-group | Clinical Science Departments | |
| pubs.organisational-group | Institutes and Centers | |
| pubs.organisational-group | Medicine | |
| pubs.organisational-group | Pediatrics | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences | |
| pubs.organisational-group | Medicine, General Internal Medicine | |
| pubs.organisational-group | Medicine, Rheumatology and Immunology | |
| pubs.organisational-group | Pediatrics, Rheumatology | |
| pubs.organisational-group | Duke Cancer Institute | |
| pubs.organisational-group | Duke Clinical Research Institute | |
| pubs.organisational-group | Institutes and Provost's Academic Units | |
| pubs.organisational-group | University Institutes and Centers | |
| pubs.organisational-group | Duke Global Health Institute | |
| pubs.organisational-group | Center for the Study of Aging and Human Development | |
| pubs.organisational-group | Initiatives | |
| pubs.organisational-group | Duke Science & Society | |
| pubs.organisational-group | Population Health Sciences | |
| pubs.organisational-group | Duke Innovation & Entrepreneurship | |
| pubs.organisational-group | Psychiatry & Behavioral Sciences, Behavioral Medicine & Neurosciences | |
| pubs.organisational-group | Duke - Margolis Center For Health Policy | |
| pubs.publication-status | Published |
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