Medication Adherence of Patients with Systemic Lupus Erythematosus and Rheumatoid Arthritis Considering the Psychosocial Factors, Health Literacy and Current Life Concerns of Patients

Background: In systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA), due to their long term, multi-drug exposure and their side effects, non-adherence to therapy is com-mon and is associated with adverse clinical outcome. In this study, we aimed to evaluate and com-pare medication adherence in patients with SLE and RA, considering their psychosocial factors, health literacy, and current life concerns. Methods: 88 patients fulfilled the criteria of RA(N:46) and SLE(N:42);using disease-modifying an-tirheumatic drugs or immunosuppressive, we evaluated their demographic data, co-morbid diseas-es, the number of medications, estimated income, having health insurance, family size and disease poor prognostic factors. The 8-item Morisky's Medication Adherence, Depression by Beck depres-sion inventory (21 Q), and drug literacy level were used. Results: Medication non-adherence was seen in 91.3% of the RA group and 90.4% of the SLE group. Moderate to very severe depression was seen in [21 (45.7%)] and [12 (25.9%)] of the RA and SLE patients, respectively. In the SLE group, depression and having poor prognostic factors, and in the RA group, depression, having co-morbid diseases, and higher pill numbers had a signifi-cant effect on medication adherence. Conclusion: There was a high prevalence of drug non-adherence in our RA and SLE patients. The most prevalent factor in non-adherence in both groups was depression. After that, in RA patients the presence of co-morbid disease and in SLE patients, the presence of poor prognostic factors were related to non-adherence. Factors like income, health insurance, disease duration, and health literacy had no significant effect on medication adherence.