Treatment Compliance Barriers in Economically Challenged, Ethnically Diverse Arthritis and Lupus Patients

New research shows that economically disadvantaged and ethnically diverse people with rheumatoid arthritis (RA) or systemic lupus erythematosus (lupus) have barriers that keep them from complying with their prescribed medical treatment: fear of side effects, belief that medicines are not working, problems with the health system environment, and medication cost. The research was funded in part by a grant from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS).

Maria G. Garcia Popa-Lisseanu, M.D., and her colleagues conducted their study at Ben Taub General Hospital in Houston, Texas. Focus-group testing was done in patients of Hispanic, African American and non-Hispanic white heritage, all from economically disadvantaged populations. They discussed the reasons why they did not always comply with their medical treatment or keep clinic appointments.

Fear of side effects was the most often-mentioned factor: although most patients were experiencing only mild side effects, they were concerned about long-term damage from continuing on the medications. Some patients felt that the prescribed drugs were not working correctly, either because they were not providing the expected relief from symptoms, or because they were not curing the disease. Problems with the health care system, such as navigating Medicaid requirements and a lack of continuity with the same doctor, also proved to be a barrier. The financial costs of the medications also kept the patients--most of whom had little or no medical coverage--from taking them as prescribed.

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