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Impact of Psychiatric Diagnosis and Treatment on Medication Adherence in Youth With Systemic Lupus Erythematosus.
- Source :
-
Arthritis care & research [Arthritis Care Res (Hoboken)] 2021 Jan; Vol. 73 (1), pp. 30-38. - Publication Year :
- 2021
-
Abstract
- Objective: Youth with systemic lupus erythematosus (SLE) experience high rates of psychiatric comorbidities, which may affect medication adherence. We undertook this study to examine the association between psychiatric disorders and hydroxychloroquine adherence and to determine whether psychiatric treatment modifies this association.<br />Methods: We identified incident hydroxychloroquine users among youth with SLE (ages 10-24 years) using de-identified US commercial insurance claims in Optum Clinformatics Data Mart (2000-2016). Adherence was estimated using medication possession ratios (MPRs) over a 365-day time period. Multivariable linear regression models were used to estimate the effect of having any psychiatric disorder on MPRs, as well as the independent effects of depression, anxiety, adjustment, and other psychiatric disorders. We tested for interactions between psychiatric diagnoses and treatment with psychotropic medications or psychotherapy.<br />Results: Among 873 subjects, 20% had a psychiatric diagnosis, most commonly depression. Only adjustment disorders were independently associated with decreased MPRs (β -0.12, P = 0.05). We observed significant crossover interactions, in which psychiatric disorders had opposite effects on adherence depending on the receipt of psychiatric treatment. Among youth with any psychiatric diagnosis, psychotropic medication use was associated with a 0.15 increase in the MPR compared with no psychotropic medication use (P = 0.02 for interaction). Among youth with depression or anxiety, psychotherapy was also associated with a higher MPR compared with no psychotherapy (P = 0.05 and P < 0.01 for interaction, respectively).<br />Conclusion: The impact of psychiatric disorders on medication adherence differed by whether youth had received psychiatric treatment. Improving recognition and treatment of psychiatric conditions may increase medication adherence in youth with SLE.<br /> (© 2020, American College of Rheumatology.)
- Subjects :
- Adolescent
Age Factors
Child
Comorbidity
Databases, Factual
Female
Humans
Lupus Erythematosus, Systemic diagnosis
Lupus Erythematosus, Systemic epidemiology
Lupus Erythematosus, Systemic psychology
Male
Mental Disorders diagnosis
Mental Disorders epidemiology
Mental Disorders therapy
Retrospective Studies
Risk Factors
United States epidemiology
Young Adult
Adolescent Behavior
Antirheumatic Agents therapeutic use
Child Behavior
Health Knowledge, Attitudes, Practice
Hydroxychloroquine therapeutic use
Lupus Erythematosus, Systemic drug therapy
Medication Adherence
Mental Disorders psychology
Subjects
Details
- Language :
- English
- ISSN :
- 2151-4658
- Volume :
- 73
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Arthritis care & research
- Publication Type :
- Academic Journal
- Accession number :
- 32937032
- Full Text :
- https://doi.org/10.1002/acr.24450