The outcome of patients with rheumatic disease, in particular rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) is variable and often unpredictable, and important differences have been observed across racial groups. Patients often show poor adherence to therapy, but the determinants and outcomes of compliance-related behaviors have not been adequately documented. We hypothesize that some of the ethnic differences in the outcome of these diseases may be related to degree of compliance with physician recommendations. The overall objective of this study is to quantify adherence to medical recommendations in patients with RA and SLE from diverse ethnic backgrounds, and to determine which are its predictors and outcomes, with an emphasis on psychosocial factors and medical interaction issues. The study will: a) compare attitudes and behaviors toward adherence to treatment in patients with RA and SLE from diverse ethnic backgrounds; b) assess the role of patient beliefs, expectations and attitudes about their disease on their adherence to treatment; c) assess the role of selected elements of the medical interaction on patients' compliance; d) evaluate ethnic differences in compliance in the context of a modified Health Belief Model (HBM); and e) determine the impact of non-compliance on patient outcomes. Phase I will use focus groups (including White, Hispanic, and Black patients) to explore the views of patients with RA and SLE toward adherence to treatment, barriers and perceived benefits. The groups will also provide information to develop scales that measure barriers and expectations in the context of the HBM. Phase 2 will be a 2-year cohort study of patients with RA and SLE from diverse ethnic backgrounds which will evaluate the determinants of adherence to treatment on the basis of the HBM, and will also examine health outcomes at the end of the 2 years according to the degree of adherence.

Agency
National Institute of Health (NIH)
Institute
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Type
Research Project (R01)
Project #
5R01AR047858-03
Application #
6734625
Study Section
Special Emphasis Panel (ZRG1-RPHB-3 (01))
Program Officer
Ader, Deborah N
Project Start
2002-04-01
Project End
2007-03-31
Budget Start
2004-04-01
Budget End
2005-03-31
Support Year
3
Fiscal Year
2004
Total Cost
$492,248
Indirect Cost
Name
Baylor College of Medicine
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
051113330
City
Houston
State
TX
Country
United States
Zip Code
77030
Street Jr, Richard L; Marengo, María F; Barbo, Andrea et al. (2015) Affective tone in medical encounters and its relationship with treatment adherence in a multiethnic cohort of patients with rheumatoid arthritis. J Clin Rheumatol 21:181-8
Marengo, María F; Suarez-Almazor, María E (2015) Improving treatment adherence in patients with rheumatoid arthritis: what are the options? Int J Clin Rheumtol 10:345-356
Waimann, Christian A; Marengo, Maria F; de Achaval, Sofia et al. (2013) Electronic monitoring of oral therapies in ethnically diverse and economically disadvantaged patients with rheumatoid arthritis: consequences of low adherence. Arthritis Rheum 65:1421-9
Marengo, M F; Waimann, C A; de Achaval, S et al. (2012) Measuring therapeutic adherence in systemic lupus erythematosus with electronic monitoring. Lupus 21:1158-65
de Achaval, Sofia; Suarez-Almazor, Maria E (2010) Treatment adherence to disease-modifying antirheumatic drugs in patients with rheumatoid arthritis and systemic lupus erythematosus. Int J Clin Rheumtol 5:313-326
de Achaval, Sofia; Suarez-Almazor, Maria E (2010) Improving treatment adherence in patients with rheumatologic disease. J Musculoskelet Med 27:
Garcia-Gonzalez, Araceli; Gonzalez-Lopez, Laura; Gamez-Nava, Jorge Ivan et al. (2009) Doctor-patient interactions in Mexican patients with rheumatic disease. J Clin Rheumatol 15:120-3
Garcia-Gonzalez, Araceli; Richardson, Marsha; Garcia Popa-Lisseanu, Maria et al. (2008) Treatment adherence in patients with rheumatoid arthritis and systemic lupus erythematosus. Clin Rheumatol 27:883-9
Suarez-Almazor, Maria E; Berrios-Rivera, Javier P; Cox, Vanessa et al. (2007) Initiation of disease-modifying antirheumatic drug therapy in minority and disadvantaged patients with rheumatoid arthritis. J Rheumatol 34:2400-7
Berrios-Rivera, Javier P; Street Jr, Richard L; Garcia Popa-Lisseanu, Maria G et al. (2006) Trust in physicians and elements of the medical interaction in patients with rheumatoid arthritis and systemic lupus erythematosus. Arthritis Rheum 55:385-93

Showing the most recent 10 out of 11 publications