Early nonadherence ups emergency care, hospitalization for lupus

Systemic lupus erythematosus patients who have just started drug therapy are at greater risk for needing acute care and possible hospitalization if they are nonadherent, based on an analysis of U.S. Medicaid beneficiaries.

Data on 9,600 new hydroxychloroquine (HCQ) and 3,829 new oral immunosuppressive medication users showed that patients who were nonadherent to their medication were 55% and 64% more likely, respectively, than those who were adherent to visit an emergency department. They also were 37% and 67% more likely to be admitted to hospital. This was after multivariate adjustment for sociodemographic factors and comorbidities.

“We also demonstrated that individuals with the poorest level of adherence had the highest rates of acute care utilization,” said lead study author Dr. Candace H. Feldman of Brigham and Women’s Hospital, Boston, and associates (Arthritis Care Res. 2015 June 19 [doi:10.1002/acr.22636]).

In addition, “moderate nonadherence was also associated with statistically significant increases in utilization” for all categories except HCQ SLE-related hospitalizations, they added.

The investigators suggested that this increased acute care utilization could represent “an opportunity to intervene to reduce avoidable morbidity and health care costs by improving adherence behavior.”

Systemic lupus erythematosus patients who have just started drug therapy are at greater risk for needing acute care and possible hospitalization if they are nonadherent, based on an analysis of U.S. Medicaid beneficiaries.

Data on 9,600 new hydroxychloroquine (HCQ) and 3,829 new oral immunosuppressive medication users showed that patients who were nonadherent to their medication were 55% and 64% more likely, respectively, than those who were adherent to visit an emergency department. They also were 37% and 67% more likely to be admitted to hospital. This was after multivariate adjustment for sociodemographic factors and comorbidities.

“We also demonstrated that individuals with the poorest level of adherence had the highest rates of acute care utilization,” said lead study author Dr. Candace H. Feldman of Brigham and Women’s Hospital, Boston, and associates (Arthritis Care Res. 2015 June 19 [doi:10.1002/acr.22636]).

In addition, “moderate nonadherence was also associated with statistically significant increases in utilization” for all categories except HCQ SLE-related hospitalizations, they added.

The investigators suggested that this increased acute care utilization could represent “an opportunity to intervene to reduce avoidable morbidity and health care costs by improving adherence behavior.”

Systemic lupus erythematosus patients who have just started drug therapy are at greater risk for needing acute care and possible hospitalization if they are nonadherent, based on an analysis of U.S. Medicaid beneficiaries.

Data on 9,600 new hydroxychloroquine (HCQ) and 3,829 new oral immunosuppressive medication users showed that patients who were nonadherent to their medication were 55% and 64% more likely, respectively, than those who were adherent to visit an emergency department. They also were 37% and 67% more likely to be admitted to hospital. This was after multivariate adjustment for sociodemographic factors and comorbidities.

“We also demonstrated that individuals with the poorest level of adherence had the highest rates of acute care utilization,” said lead study author Dr. Candace H. Feldman of Brigham and Women’s Hospital, Boston, and associates (Arthritis Care Res. 2015 June 19 [doi:10.1002/acr.22636]).

In addition, “moderate nonadherence was also associated with statistically significant increases in utilization” for all categories except HCQ SLE-related hospitalizations, they added.

The investigators suggested that this increased acute care utilization could represent “an opportunity to intervene to reduce avoidable morbidity and health care costs by improving adherence behavior.”