Evidence map›Paper›PMID 38825351›Full record

ArticleThe Journal of rheumatology2024

Implementation of a Clinician-led Medication Adherence Intervention Among Patients With Systemic Lupus Erythematosus.

Kai Sun, Nneka J Molokwu, Emily Hanlen-Rosado, Amy L Corneli, Kathryn I Pollak, Jennifer L Rogers, Rebecca E Sadun, Lisa G Criscione-Schreiber, Jayanth Doss, Hayden B Bosworth and 1 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Journal of rheumatology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Kai SunK. Sun, MD, MS, J.L. Rogers, MD, L.G. Criscione-Schreiber, MD, MEd, J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine; kai.sun@duke.edu.ORCID 0000-0002-8406-2932
Nneka J MolokwuN.J. Molokwu, MSW, E. Hanlen-Rosado, MPH, MEd, A.L. Corneli, PhD, K.I. Pollak, PhD, H.B. Bosworth, PhD, Department of Population Health Sciences, Duke University School of Medicine.
Emily Hanlen-RosadoN.J. Molokwu, MSW, E. Hanlen-Rosado, MPH, MEd, A.L. Corneli, PhD, K.I. Pollak, PhD, H.B. Bosworth, PhD, Department of Population Health Sciences, Duke University School of Medicine.
Amy L CorneliN.J. Molokwu, MSW, E. Hanlen-Rosado, MPH, MEd, A.L. Corneli, PhD, K.I. Pollak, PhD, H.B. Bosworth, PhD, Department of Population Health Sciences, Duke University School of Medicine.ORCID 0000-0002-4629-4329
Kathryn I PollakN.J. Molokwu, MSW, E. Hanlen-Rosado, MPH, MEd, A.L. Corneli, PhD, K.I. Pollak, PhD, H.B. Bosworth, PhD, Department of Population Health Sciences, Duke University School of Medicine.
Jennifer L RogersK. Sun, MD, MS, J.L. Rogers, MD, L.G. Criscione-Schreiber, MD, MEd, J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine.ORCID 0000-0003-1755-7684
Rebecca E SadunR.E. Sadun, MD, PhD, Division of Rheumatology and Immunology, Department of Medicine, Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.
Lisa G Criscione-SchreiberK. Sun, MD, MS, J.L. Rogers, MD, L.G. Criscione-Schreiber, MD, MEd, J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine.
Jayanth DossK. Sun, MD, MS, J.L. Rogers, MD, L.G. Criscione-Schreiber, MD, MEd, J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine.ORCID 0000-0002-7326-7107
Hayden B BosworthN.J. Molokwu, MSW, E. Hanlen-Rosado, MPH, MEd, A.L. Corneli, PhD, K.I. Pollak, PhD, H.B. Bosworth, PhD, Department of Population Health Sciences, Duke University School of Medicine.ORCID 0000-0001-6188-9825
Megan E B ClowseK. Sun, MD, MS, J.L. Rogers, MD, L.G. Criscione-Schreiber, MD, MEd, J. Doss, MD, MPH, M.E.B. Clowse, MD, MPH, Division of Rheumatology and Immunology, Department of Medicine, Duke University School of Medicine.ORCID 0000-0002-8579-3470

Funding

Institutional Career Development CoreKL2TR002554 · NCATS · DUKE UNIVERSITY · PI SVETKEY, LAURA P · 2018 to 2022
$8.2M
CO-LEADER: Intervention to Improve Patient-Provider Communication and Medication Adherence among Patients with Systemic Lupus ErythematosusR01MD018977 · NIMHD · DUKE UNIVERSITY · PI Kai Sun · 2023 to 2026
$2.4M
NCATS NIH HHS KL2 TR002554NIMHD NIH HHS R01 MD018977
6 · The paper itself

Abstract

objectiveMedication nonadherence in systemic lupus erythematosus (SLE) leads to poor clinical outcomes. We developed a clinician-led adherence intervention that involves reviewing real-time pharmacy refill data and using effective communication to address nonadherence. Prior pilot testing showed promising effects on medication adherence. Here, we describe further evaluation of how clinicians implemented the intervention and identify areas for improvement.

methodsWe audio recorded encounters of clinicians with patients who were nonadherent (90-day proportion of days covered [PDC] < 80% for SLE medications). We coded recordings for intervention components performed, communication quality, and time spent discussing adherence. We also conducted semistructured interviews with patients and clinicians on their experiences and suggestions for improving the intervention. We assessed change in 90-day PDC post intervention.

resultsWe included 25 encounters with patients (median age 39, 100% female, 72% Black) delivered by 6 clinicians. Clinicians performed most intervention components consistently and exhibited excellent communication, as coded by objective coders. Adherence discussions took an average of 3.8 minutes, and 44% of patients had ≥ 20% increase in PDC post intervention. In structured interviews, many patients felt heard and valued and described being more honest about nonadherence and more motivated to take SLE medications. Patients emphasized patient-clinician communication and financial and logistical assistance as areas for improvement. Some clinicians wanted additional resources and training to improve adherence conversations.

conclusionWe provide further evidence to support the feasibility, acceptability, and fidelity of the adherence intervention. Future work will optimize clinician training and evaluate the intervention's effectiveness in a large, randomized trial.

Indexed as

Lupus Erythematosus, SystemicMedication AdherenceAdultCommunicationFemaleHumansMaleMiddle AgedPhysician-Patient Relationsinterventionmedication adherencepatient-clinician communicationsystemic lupus erythematosus

Identifiers

PMID38825351
PMCPMC11368627

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.