Higher medication adherence improves health-related quality of life in sarcoidosis
Among patients with sarcoidosis, higher medication adherence was associated with improved health-related quality of life, with Black patients more likely to report medication nonadherence, according to observational data published in Chest.
“We found that higher medication adherence was associated with better health-related quality of life by a sarcoidosis-specific measure (King’s Sarcoidosis Health Questionnaire) and the St. George’s Respiratory Questionnaire,” Michelle Sharp, MD, co-director of the Johns Hopkins Sarcoidosis Program and assistant professor of medicine at Johns Hopkins University School of Medicine, and colleagues wrote. “Despite the known importance of medication adherence in other chronic pulmonary diseases, medication adherence has never been assessed or targeted as a possible way to improve outcomes in sarcoidosis.”
The observational study enrolled 117 adult patients (57% women; 55% Black; median age, 57 years) from the Johns Hopkins Sarcoidosis Clinic with a diagnosis of pulmonary sarcoidosis. Nearly half (47%) were prescribed both corticosteroids and steroid-sparing agents, 34% were prescribed steroids only and 19% were prescribed steroid sparing agents only.
Patients were administered questionnaires to assess medication adherence, health-related quality of life, health care utilization and sociodemographic information. Medical charts were used to evaluate lung function, disease duration, comorbidities and sarcoidosis organ involvement.
Of 117 patients, 66% reported at least one nonadherent behavior (Medication Adherence Report Scale score < 25). Higher medication adherence was associated with better health-related quality of life scores measured by both the Medical Adherence Report Scale and St. George’s Respiratory questionnaires (P < .05).
Black patients reported lower medication adherence compared with white participants (P < .05).
“Our finding of lower medication adherence among Blacks is consistent with findings in other chronic diseases that have shown lower rates of medication adherence in Blacks,” Sharp and colleagues wrote. “More research is needed to examine this potential mechanism between race and medication adherence in sarcoidosis.”
Researchers found no association between medication adherence and health care utilization, FVC percent predicted, FEV1 percent predicted or diffusion capacity of the lungs for carbon monoxide percent predicted.
According to the researchers, medication adherence may be an important factor to assess the real-world effectiveness of medication regimens when treating patients with sarcoidosis.
“There are significant health disparities in sarcoidosis,” Sharp told Healio. “Medical adherence may be an important target to improve clinical outcomes and reduce disparities. More research needs to be done to investigate the full impact of adherence and the determinants of non-adherence.”
For more information:
Michelle Sharp, MD, can be reached at firstname.lastname@example.org.
Editor’s note: This article was updated on July 23, 2020, with original quotes from Michelle Sharp, MD.