{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T00:19:24Z","timestamp":1782951564685,"version":"3.54.5"},"reference-count":26,"publisher":"The Journal of Rheumatology","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2024,5,10]]},"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Medication nonadherence in systemic lupus erythematosus (SLE) leads to poor clinical outcomes. We developed a clinician-led adherence intervention that involves reviewing real-time pharmacy refill data and using effective communication to address nonadherence. Prior pilot testing showed promising effects on medication adherence. Here, we describe further evaluation of how clinicians implemented the intervention and identify areas for improvement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We audio recorded encounters of clinicians with patients who were nonadherent (90-day proportion of days covered [PDC] &lt; 80% for SLE medications). We coded recordings for intervention components performed, communication quality, and time spent discussing adherence. We also conducted semistructured interviews with patients and clinicians on their experiences and suggestions for improving the intervention. We assessed change in 90-day PDC post intervention.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We included 25 encounters with patients (median age 39, 100% female, 72% Black) delivered by 6 clinicians. Clinicians performed most intervention components consistently and exhibited excellent communication, as coded by objective coders. Adherence discussions took an average of 3.8 minutes, and 44% of patients had \u2265 20% increase in PDC post intervention. In structured interviews, many patients felt heard and valued and described being more honest about nonadherence and more motivated to take SLE medications. Patients emphasized patient-clinician communication and financial and logistical assistance as areas for improvement. Some clinicians wanted additional resources and training to improve adherence conversations.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We provide further evidence to support the feasibility, acceptability, and fidelity of the adherence intervention. Future work will optimize clinician training and evaluate the intervention\u2019s effectiveness in a large, randomized trial.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.2024-0071","type":"journal-article","created":{"date-parts":[[2024,6,2]],"date-time":"2024-06-02T14:30:25Z","timestamp":1717338625000},"page":"884-890","source":"Crossref","is-referenced-by-count":5,"title":["Implementation of a Clinician-led Medication Adherence Intervention Among Patients With Systemic Lupus Erythematosus"],"prefix":"10.3899","volume":"51","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8406-2932","authenticated-orcid":false,"given":"Kai","family":"Sun","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nneka J.","family":"Molokwu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Hanlen-Rosado","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4629-4329","authenticated-orcid":false,"given":"Amy L.","family":"Corneli","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathryn I.","family":"Pollak","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1755-7684","authenticated-orcid":false,"given":"Jennifer L.","family":"Rogers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca E.","family":"Sadun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lisa G.","family":"Criscione-Schreiber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7326-7107","authenticated-orcid":false,"given":"Jayanth","family":"Doss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6188-9825","authenticated-orcid":false,"given":"Hayden B.","family":"Bosworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8579-3470","authenticated-orcid":false,"given":"Megan E.B.","family":"Clowse","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2024,6,1]]},"reference":[{"key":"2024090105300591000_51.9.884.1","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kem016"},{"key":"2024090105300591000_51.9.884.2","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":"2024090105300591000_51.9.884.3","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":"2024090105300591000_51.9.884.4","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-157-11-201212040-00538"},{"key":"2024090105300591000_51.9.884.5","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110771"},{"key":"2024090105300591000_51.9.884.6","doi-asserted-by":"crossref","first-page":"1400","DOI":"10.1002\/acr.23302","article-title":"Can patient navigators improve adherence to disease-modifying antirheumatic drugs? 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