Internal Medicine
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Browsing Internal Medicine by Subject "adherence"
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Item Effect of level of adherence of antimalarials on disease activity and its determinants in Systemic lupus erythematous patients on follow up at rheumatology clinic of Tikur Anbessa Specialized Hospital(Addis Ababa University, 2024-05) Beyene,Eden Tesfaye; Demelash,Berhanu(MD)Background: Systemic lupus erythematous (SLE) is an autoimmune disease associated with accrual of organ damage and mortality. Antimalarials like Hydroxychloroquine/Chloroquine are important therapeutic options in SLE. But their effectiveness is impeded by non-adherence. Objective: To assess the level of adherence of antimalarials, its determinants and its association to disease activity in SLE patients on follow up at the rheumatology clinic of Tikur Anbessa Specialized Hospital (TASH). Methods: 106 SLE patients taking antimalarials and who had follow up visit from August 1 to October 31 2023 were included in the study. Structured questionnaire was used to assess their sociodemographic and clinical characteristics. Adherence was assessed using Morisky medication adherence scale (MMAS-8) and SLE disease activity was assessed using systemic lupus erythematous disease activity index 2000 (SLEDAI-2K). Data was analyzed using statistical package for social science (SPSS) version 26. Binary logistic regression was used to assess the association between level of adherence and disease activity and to look for clinical predictors of non-adherence. Statistical significance was determined using adjusted odds ratio at 95% confidence interval (CI) and P value <0.05. Results: 98.1% were women and the mean age of the patients was 28.8 years. 91.5% were on chloroquine and 8.5% were taking hydroxychloroquine. 11.3% were on high dose prednisolone. 36.8% of patients were found to be non-adherent to their antimalarials and 53.8% had active disease. Non adherence was seen to have a significant association with active disease (AOR 9.86 95% CI 3.61, 26.87). None of the sociodemographic and clinical factors were found to be predictors of non-adherence. (P>0.2) Conclusion: SLE patients in this study had a fair adherence to antimalarials. There is a strong association between non-adherence to antimalarial and active disease in SLE patients. Sociodemographic and clinical factors were not found to be predictors of medication adherence.