Lupus & antiphospholipid syndrome
Barriers to therapy adherence in a group of Italian patients with systemic lupus erythematosus
Authors' conclusion
NAT is prevalent among Italian SLE patients and is driven by a combination of modifiable patient, therapy, and healthcare system barriers. Younger patients are at high risk of NAT due to behavioural and psychosocial barriers.
Study context
- Population
- Adult Italian patients with systemic lupus erythematosus (SLE)
- Participants
- 432 patients
- Outcome
- Prevalence of non-adherence to therapy (NAT; Medication Adherence Self-Report Inventory (MASRI) adherence rate <80%)
Methodological detailsmulticentre
- Multicentre
Main finding
As reported in the abstract
Prevalence of NAT
Non-adherence to therapy (NAT) observed
38%
Observational data: associations, not effects.
Further findings
Factors associated with NAT
- Younger age
- P < 0.001
- Higher Hospital Anxiety and Depression Scale (HADS) scores
- P < 0.001
Patient-related barriers associated with NAT
- Forgetfulness, OR
- OR=11.56, p<0.001
- Daily routine changes, OR
- OR=5.29, p<0.001
- Perceived hassle, OR
- OR=4.85, p<0.001
Therapy-related barriers associated with NAT
- Fear of side effects, OR
- OR=29.15, p<0.001
- Suffering side effects, OR
- OR=5.73, p<0.001
Socioeconomic barriers associated with NAT
- Cost concerns (only socioeconomic barrier associated), OR
- OR=3.75, p=0.002
Healthcare system-related barriers (more frequent in NAT)
- Long waiting list, OR
- OR=2.01, p=0.003
- Divergent medical opinions, OR
- OR=2.10, p=0.001
- Prescribed delay, OR
- OR=2.36, p=0.004
ROC analysis of age
- Age ≤48 years associated with NAT and related behavioural barriers
Original publication
Barriers to therapy adherence in a group of Italian patients with systemic lupus erythematosus. Clin Exp Rheumatol. Published 15 July 2025. doi:10.
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