Talk to the Veterans Crisis Line now
U.S. flag
An official website of the United States government

Health Services Research & Development

Go to the ORD website
Go to the QUERI website

HSR&D Citation Abstract

Search | Search by Center | Search by Source | Keywords in Title

Barriers to taking medications for systemic lupus erythematosus: a qualitative study of racial minority patients, lupus providers, and clinic staff.

Sun K, Corneli AL, Dombeck C, Swezey T, Rogers JL, Criscione-Schreiber LG, Sadun RE, Eudy AM, Doss J, Bosworth HB, Clowse M. Barriers to taking medications for systemic lupus erythematosus: a qualitative study of racial minority patients, lupus providers, and clinic staff. Arthritis care & research. 2021 Mar 4.

Related HSR&D Project(s)

Dimensions for VA is a web-based tool available to VA staff that enables detailed searches of published research and research projects.

If you have VA-Intranet access, click here for more information vaww.hsrd.research.va.gov/dimensions/

VA staff not currently on the VA network can access Dimensions by registering for an account using their VA email address.
   Search Dimensions for VA for this citation
* Don't have VA-internal network access or a VA email address? Try searching the free-to-the-public version of Dimensions



Abstract:

OBJECTIVE: Underrepresented racial and ethnic minorities are disproportionately affected by systemic lupus erythematosus (SLE). Racial and ethnic minorities also have more severe SLE manifestations that require use of immunosuppressive medications, and often have lower rates of medication adherence. We aimed to explore barriers of adherence to SLE immunosuppressive medications among minority SLE patients. METHODS: We conducted a qualitative descriptive study using in-depth interviews with a purposeful sample of 1) racial minority SLE patients taking oral immunosuppressants (methotrexate, azathioprine, or mycophenolate), and 2) lupus clinic providers and staff. Interviews were audio-recorded, transcribed, and analyzed using applied thematic analysis. We grouped themes using the Capability, Opportunity, Motivation, Behavior conceptual model. RESULTS: We interviewed 12 SLE patients (4 adherent, 8 non-adherent) and 12 providers and staff. We identified Capability barriers to include external factors related to acquiring medications, specifically cost, pharmacy, and clinic related issues; Opportunity barriers to include external barriers to taking medications, specifically logistic and medication related issues; and Motivation factors to include intrinsic barriers, encompassing patients' knowledge, beliefs, attitudes, and physical and mental health. The most frequently described barriers were cost, side effects, busyness/forgetting, and lack of understanding, although barriers differed by patient and adherence level, with logistic and intrinsic barriers described predominantly by non-adherent patients and side effects described predominantly by adherent patients. CONCLUSION: Our findings suggest that interventions may be most impactful if they are designed to facilitate logistics of taking medications and increase patients' motivation while allowing for personalization to address the individual differences in adherence barriers.





Questions about the HSR&D website? Email the Web Team.

Any health information on this website is strictly for informational purposes and is not intended as medical advice. It should not be used to diagnose or treat any condition.