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Predictors of medication non-adherence for vasculitis patients

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Abstract

The primary purpose of this article is to document whether demographic, clinical, regimen-related, intrapersonal, and interpersonal factors predict medication non-adherence for vasculitis patients. A secondary purpose is to explore whether adherence varies by medication type and whether patients experienced drug-related side effects. Vasculitis patients (n = 228) completed online baseline and 3-month follow-up surveys. Demographic (age, gender, education, race, marital status, and insurance status), clinical (perceived vasculitis severity, disease duration, vasculitis type, and relapse/remission status), regimen-related (experience of side effects), intrapersonal (depressive symptoms), and interpersonal (adherence-related support from family and friends) factors were measured at baseline. Medication non-adherence was assessed at follow-up using the Vasculitis Self-Management Survey medication adherence subscale (α = 0.89). Variables that significantly correlated (p < 0.05) with non-adherence were included in a linear regression model to predict non-adherence. Younger age (r = −0.23, p < 0.001), female sex (r = 0.16, p < 0.05), experience of side effects (r = 0.15, p < 0.05), and more depressive symptoms (r = 0.22, p < 0.001) were associated with more medication non-adherence. In the regression model, younger age (β = −0.01, p = 0.01) and more depressive symptoms (β = 0.01 p = 0.02) predicted worse adherence. For six out of eight vasculitis medication types, patients who experienced side effects were less adherent than patients who did not experience side effects. Multiple factors are associated with medication non-adherence for vasculitis patients. Providers should discuss medication adherence and drug-related side effects with vasculitis patients. Providers may want to particularly target younger patients and patients with clinical signs of depression.

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Acknowledgments

We would like to thank the Vasculitis Foundation, its support group leaders, Vasculitis Foundation Canada, Wegener’s Granulomatosis Support Group Of Australia Inc, the Glomerular Disease Collaborative Network, the UNC Kidney Center (especially Ronald J. Falk, Kristen Hendrickson, and Caroline E. Jennette), and Jim Bornac for their help with recruitment. This work was supported by the Renal Epidemiology Predoctoral Traineeship at the UNC Kidney Center (T32DK007750), the Thurston Arthritis Research Center Postdoctoral Fellowship (5T32-AR007416), and the ACR REF/Abbott Health Professional Graduate Medical Student Research Preceptorship. The project described also was supported by the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through Grant KL2TR000084. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

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Authors and Affiliations

  1. Division of Pharmaceutical Outcomes and Policy, CB#7573, Eshelman School of Pharmacy, University of North Carolina, Chapel Hill, NC, 27599, USA

    Delesha M. Carpenter

  2. UNC Kidney Center, CB#7155, School of Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA

    Susan L. Hogan

  3. Thurston Arthritis Research Center, CB#7280, School of Medicine, University of North Carolina, Chapel Hill, NC, 27599, USA

    Robert F. DeVellis

Authors
  1. Delesha M. Carpenter
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  2. Susan L. Hogan
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  3. Robert F. DeVellis
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Correspondence to Delesha M. Carpenter.

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Carpenter, D.M., Hogan, S.L. & DeVellis, R.F. Predictors of medication non-adherence for vasculitis patients. Clin Rheumatol 32, 649–657 (2013). https://doi.org/10.1007/s10067-013-2164-z

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  • DOI: https://doi.org/10.1007/s10067-013-2164-z

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