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Relationship between adherence to study and clinic visits in systemic lupus erythematosus patients: data from the LUMINA cohort

Department of Medicine, Division of Clinical Immunology and Rheumatology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, AL, USA

K T Ho

Division of Rheumatology and Clinical Immunogenetics, The University of Texas Health Science Center, Houston, TX, USA

B Agee

Department of Medicine, Division of Clinical Immunology and Rheumatology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, AL, USA

G McGwin, Jr

Departments of Surgery (Section of Trauma, Burns, and Critical Care) and Epidemiology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, AL, USA

B J Fessler

Department of Medicine, Division of Clinical Immunology and Rheumatology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, AL, USA

H M Bastian

Department of Medicine, Division of Clinical Immunology and Rheumatology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, AL, USA

J D Reveille

Division of Rheumatology and Clinical Immunogenetics, The University of Texas Health Science Center, Houston, TX, USA

G S Alarcón

Department of Medicine, Division of Clinical Immunology and Rheumatology, Schools of Medicine and Public Health, The University of Alabama at Birmingham, Birmingham, Alabama, AL, USA, graciela.alarcon{at}ccc.uab.edu

The aim of this study was to examine the relationship between nonadherence with study visits and with regularly scheduled clinic visits after adjusting for other patient and disease characteristics. One hundred and forty-one LUMINA patients with appointment data in the institutions’ computerized systems (UAB and UTH) were studied. ‘No shows’ were assessed as the percentage of appointments not attended for either rheumatology, other clinics and LUMINA visits (from zero to 100%). Eighty-nine percent of the patients were women, 40% were Caucasians, 55% African-Americans and 5% Hispanics. ‘No shows’ to rheumatology were associated with non-Caucasian ethnicity, younger age, single marital status, lack of home ownership, ‘no shows’ to other clinics and to the LUMINA study, greater disease activity and to some disease manifestations (serositis, renal involvement, positive anti-dsDNA antibodies). In multivariable analyses, features predictive of rheumatology ‘no shows’ were lack of home ownership, ‘no shows’ to LUMINA study visits, renal involvement and serosal manifestations. Nonadherence with study visits and with regularly scheduled care at rheumatology clinics were associated. Other factors predictive of nonadherence to recommended care were lack of home ownership (a measurement of low socioeconomic status) and the presence of disease manifestations (i.e., renal or serosal involvement). These data should be considered when caring for patients with SLE.

Key Words: adherence • clinic visits • study visits • systemic lupus erythematosus

Lupus, Vol. 13, No. 8, 561-568 (2004)
DOI: 10.1191/0961203304lu1061oa


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