ArticleSeminars in arthritis and rheumatism2018
Dynamic patterns and predictors of hydroxychloroquine nonadherence among Medicaid beneficiaries with systemic lupus erythematosus.
Article in Seminars in arthritis and rheumatism, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
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Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Medication Adherence Trajectories: A Systematic Literature Review.Journal of managed care & specialty pharmacy · 2020Pooled it
- Feasibility and acceptability of an innovative adherence intervention for young adults with childhood-onset systemic Lupus Erythematosus.Pediatric rheumatology online journal · 2020Trial
- Racial differences in cardiovascular events and adverse pregnancy outcomes among pregnant individuals with SLE.Lupus science & medicine · 2026Article
- Sex and gender differences in rheumatology: clinical impact and future directions.Nature reviews. Rheumatology · 2026Review
- Defining Optimally Safe and Effective Blood Levels of Hydroxychloroquine in Lupus: An Important Step Toward Precision Drug Monitoring.Arthritis & rheumatology (Hoboken, N.J.) · 2026Observational
- The incidence and mortality of connective tissue diseases: a population-level cohort study in England from 2012 to 2023.Rheumatology (Oxford, England) · 2025Article
- Lupus nephritis.Nature reviews. Disease primers · 2025Review
- Item-specific factors associated with damage accrual in systemic lupus erythematosus: insights from a multiethnic, multinational Latin American cohort.Lupus science & medicine · 2025Article
- Sex- and gender-related differences in systemic lupus erythematosus: a scoping review.Rheumatology international · 2025Article
- Investigating the Time-Varying Nature of Medication Adherence Predictors: An Experimental Approach Using Andersen's Behavioral Model of Health Services Use.Pharmacy (Basel, Switzerland) · 2025Article
- Refining lupus management: a comprehensive review of HCQ blood levels.Rheumatology advances in practice · 2025Review
- Effect of an Electronic Pill Bottle on Hydroxychloroquine Adherence in Pediatric Lupus: Results of a Novel Direct-to-Family Pilot Trial.ACR open rheumatology · 2025Article
- Therapeutic Hydroxychloroquine Blood Levels Are Associated With Fewer Hospitalizations and Possible Reduction of Health Disparities in Lupus.Arthritis care & research · 2024Article
- Trajectories of disease severity and their clinical outcome in real-world patients with systemic lupus erythematosus.Heliyon · 2024Article
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- Real-world treatment patterns in patients with systemic lupus erythematosus: associations with comorbidities and damage.Lupus science & medicine · 2024Article
- A Bitter Pill to Swallow: The Challenge of Medication Nonadherence in Systemic Lupus Erythematosus.The Journal of rheumatology · 2024Article
- Risk Factors for Hydroxychloroquine Retinopathy and Its Subtypes.JAMA network open · 2024Article
- Interpreting hydroxychloroquine blood levels for medication non-adherence: a pharmacokinetic study.Lupus science & medicine · 2024Article
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Authors and funding
7 authors.
Funding
Abstract
backgroundHydroxychloroquine (HCQ) is the standard of care medication for most SLE patients, however nonadherence is common. We investigated longitudinal patterns and predictors of nonadherence to HCQ in a U.S. SLE cohort of HCQ initiators.
methodsWe used Medicaid data from 28 states to identify adults 18-65 years with prevalent SLE. We included HCQ initiators following ≥6 months without use, and required ≥1 year of follow-up after first dispensing (index date). We used the proportion of days covered (PDC) to describe overall HCQ adherence (<80% = nonadherent) and novel group-based trajectory models (GBTM) to examine monthly patterns (<80% of days/month covered = nonadherent), during the first year of use. Multivariable multinomial logistic regression models were used to examine predictors of nonadherence.
resultsWe identified 10,406 HCQ initiators with SLE. Mean age was 38 (±12) years, 94% were female, 42% black, 31% white; 85% had a mean PDC < 80%. In our 4-group GBTM, 17% were persistent adherers, 36% persistent nonadherers, and 47% formed two dynamic patterns of partial adherence. Adherence declined for most patients over the first year. Compared to persistent adherers, the odds of nonadherence were increased for blacks and Hispanics vs. whites and for younger ages vs. older; increased SLE-related comorbidities were associated with reduced odds of nonadherence for persistent nonadherers (0.95, 95% CI: 0.91-0.99).
conclusionsAmong HCQ initiators with SLE, we observed poor adherence which declined for most over the first year of use. HCQ adherence is a dynamic behavior and further studies of associated predictors, outcomes, and interventions should reflect this.
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