Depression, medication adherence, and service utilization in systemic lupus erythematosus

摘要: Objective Forgetting to take medications is an important cause of nonadherence. This study evaluated factors associated with forgetting in a large cohort persons systemic lupus erythematosus (SLE) participating the University California, San Francisco Lupus Outcomes Study (LOS). Relationships among adherence problems and service utilization (outpatient visits, emergency department hospitalizations) were also evaluated. Methods The consisted 834 LOS participants who provided self-reported frequency as directed. Predictors patterns included sociodemographics, disease-related characteristics (e.g., disease activity, recent SLE flare), mental health (Center for Epidemiologic Studies Depression Scale cognitive function screen). Health care presence quantity visits rheumatologists, primary physicians, other providers, departments, hospitalizations. Results Forty-six percent reported at least some time. Depressive symptom severity was strong predictor difficulties (odds ratio [OR] 1.04, 95% confidence interval [95% CI] 1.02–1.05; P < 0.0001) after accounting all predictors. Persons reporting had significantly greater numbers outpatient rheumatology more likely visit (OR 1.45, CI 1.04–2.04; = 0.03). Conclusion Depression may be medication problems, are high-cost utilization, specifically visits. In era rapidly evolving treatments lupus, identifying patients risk decrease medical expenditures improve patient outcomes SLE.