{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T10:11:17Z","timestamp":1780654277155,"version":"3.54.1"},"reference-count":32,"publisher":"The Journal of Rheumatology","issue":"10","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2019,1,10]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective.<\/jats:title>\n                    <jats:p>Hydroxychloroquine (HCQ) is a cornerstone to managing systemic lupus erythematosus (SLE), yet adherence to medication is poor. We sought to measure the association of adherence with 5 \u201cdimensions of adherence\u201d as articulated by the World Health Organization for chronic conditions: the patient\u2019s socioeconomic status, and patient-, condition-, therapy-, and healthcare system\u2013related factors. Our longterm goal is to generate evidence to design effective interventions to increase adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods.<\/jats:title>\n                    <jats:p>The retrospective cohort study included Kaiser Permanente Northern California patients \u2265 18 years old during 2006\u20132014, with SLE and \u2265 2 consecutive prescriptions for HCQ. Adherence was calculated from the medication possession ratio and dichotomized as &lt; 80% versus \u2265 80%. Predictor variables were obtained from the electronic medical record and census data. We used multivariable logistic regression to estimate adjusted OR and 95% CI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results.<\/jats:title>\n                    <jats:p>The study included 1956 patients. Only 58% of patients had adherence \u2265 80%. In adjusted analyses, socioeconomic variables did not predict adherence. Increasing age (65\u201389 yrs compared with \u2264 39 yrs: OR 1.44, 95% CI 1.07\u20131.93), white race (p &lt; 0.05), and the number of rheumatology visits in the year before baseline (\u2265 3 compared with 0 or 1: OR 1.47, 95% CI 1.18\u20131.83) were positively associated with adherence. The rheumatologist and medical center providing care were not associated with adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion.<\/jats:title>\n                    <jats:p>At our setting, as in other settings, about half of patients with SLE were not adherent to HCQ therapy. Differences in adherence by race\/ethnicity suggest the possibility of using tailored interventions to increase adherence. Qualitative research is needed to elucidate patient preferences for adherence support.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3899\/jrheum.180946","type":"journal-article","created":{"date-parts":[[2019,2,1]],"date-time":"2019-02-01T12:38:29Z","timestamp":1549024709000},"page":"1309-1315","source":"Crossref","is-referenced-by-count":30,"title":["Understanding Nonadherence with Hydroxychloroquine Therapy in Systemic Lupus Erythematosus"],"prefix":"10.3899","volume":"46","author":[{"given":"Lucy H.","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Helene B.","family":"Fevrier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Goldfien","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anke","family":"Hemmerling","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa J.","family":"Herrinton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2019,2,1]]},"reference":[{"key":"2026040106401354000_46.10.1309.1","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/RHU.0b013e31817a242a","article-title":"Adherence to medications in systemic lupus erythematosus","volume":"14","author":"Koneru","year":"2008","journal-title":"J Clin Rheumatol"},{"key":"2026040106401354000_46.10.1309.2","doi-asserted-by":"crossref","first-page":"1712","DOI":"10.1002\/acr.22636","article-title":"Medication nonadherence is associated with increased subsequent acute care utilization among medicaid beneficiaries with systemic lupus erythematosus","volume":"67","author":"Feldman","year":"2015","journal-title":"Arthritis Care Res"},{"key":"2026040106401354000_46.10.1309.3","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2008.101766"},{"key":"2026040106401354000_46.10.1309.4","unstructured":"World Health Organization . Adherence to long-term therapies: evidence for action. [Internet. 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Usefulness of FaceTime to improve medication adherence in adolescents and young adults with systemic lupus erythematosus: a case series. Rheumatology: Current Research [Internet. Accessed March 28, 2019.] Available from: www.omicsonline.org\/open-access\/usefulness-of-facetime-to-improve-medication-adherence-in-adolescents-andyoung-adults-with-systemic-lupus-erythematosus-a-case-series-2161-1149-1000153.php?aid=54701"},{"key":"2026040106401354000_46.10.1309.19","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1177\/1524839917710893","article-title":"Reach out churches: a community-based participatory research pilot trial to assess the feasibility of a mobile health technology intervention to reduce blood pressure among African Americans","volume":"19","author":"Skolarus","year":"2018","journal-title":"Health Promot Pract"},{"key":"2026040106401354000_46.10.1309.20","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-018302"},{"key":"2026040106401354000_46.10.1309.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-019463"},{"key":"2026040106401354000_46.10.1309.22","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1007\/s11096-018-0593-0","article-title":"Efficacy of a telephone-based intervention among patients with type-2 diabetes; a randomized controlled trial in pharmacy practice","volume":"40","author":"Sarayani","year":"2018","journal-title":"Int J Clin Pharm"},{"key":"2026040106401354000_46.10.1309.23","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1188\/18.ONF.69-76","article-title":"Use of a smartphone application for prompting oral medication adherence among adolescents and young adults with cancer","volume":"45","author":"Wu","year":"2018","journal-title":"Oncol Nurs Forum"},{"key":"2026040106401354000_46.10.1309.24","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1177\/0009922816684857","article-title":"A randomized trial of user-controlled text messaging to improve asthma outcomes: a pilot study","volume":"56","author":"Britto","year":"2017","journal-title":"Clin Pediatr"},{"key":"2026040106401354000_46.10.1309.25","doi-asserted-by":"publisher","DOI":"10.1002\/art.24236"},{"key":"2026040106401354000_46.10.1309.26","doi-asserted-by":"publisher","DOI":"10.7326\/M13-1705"},{"key":"2026040106401354000_46.10.1309.27","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.151094"},{"key":"2026040106401354000_46.10.1309.28","doi-asserted-by":"crossref","first-page":"1074","DOI":"10.1002\/cpt.885","article-title":"A prospective international study on adherence to treatment in 305 patients with flaring SLE: assessment by drug levels and self-administered questionnaires","volume":"103","author":"Costedoat-Chalumeau","year":"2018","journal-title":"Clin Pharmacol Ther"},{"key":"2026040106401354000_46.10.1309.29","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.150379"},{"key":"2026040106401354000_46.10.1309.30","first-page":"527","article-title":"Dosing frequency and medication adherence in chronic disease","volume":"18","author":"Coleman","year":"2012","journal-title":"J Manag Care Pharm"},{"key":"2026040106401354000_46.10.1309.31","first-page":"35","article-title":"Adherence and health care costs","volume":"7","author":"Iuga","year":"2014","journal-title":"Risk Manag Healthc Policy"},{"key":"2026040106401354000_46.10.1309.32","unstructured":"Viswanathan M Golin CE Jones CD Ashok M Blalock S Wines RC Closing the quality gap: revisiting the state of the science (vol. 4: medication adherence interventions: comparative effectiveness). 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