TOPLINE

Among patients with newly diagnosed primary Sjögren disease (pSjD), 40% demonstrated low medication adherence during follow-up. Adherence was associated with patients' beliefs about the necessity of treatment vs concerns about potential harm, rather than with disease activity, symptom burden, or quality of life.

METHODOLOGY

• A prospective observational cohort study enrolled 54 patients (mean age, 49.7 years; 96.3% women) with newly diagnosed pSjD meeting the 2016 American College of Rheumatology/European League Against Rheumatism classification criteria.
• Participants were followed for a mean of 21.36 months, and at follow-up, 40 patients (74.1%) were available for reassessment.
• Medication adherence was assessed at follow-up using the 5-item Compliance Questionnaire for Rheumatology, which categorized patients into low-adherence (n = 16, 40.0%) and high-adherence (n = 24, 60.0%) groups.
• Researchers evaluated systemic disease activity using the EULAR Sjögren Syndrome Disease Activity Index (ESSDAI) and patient-reported symptom burden with the EULAR Sjögren Syndrome Patient Reported Index (ESSPRI); additional assessments included psychological symptoms via the Hospital Anxiety and Depression Scale, functional status with the Health Assessment Questionnaire, and health-related quality of life using the 12-item Short Form Health Survey, all measured at baseline and follow-up.
• Patients' beliefs about medicines were assessed using the Beliefs about Medicines Questionnaire at follow-up, comparing perceived necessity vs concern and calculating a necessity-concern differential.

TAKEAWAY

• Patients with low adherence had a significantly lower necessity-concern differential (mean, -0.43 vs 0.30; P = .038), indicating they perceived less benefit relative to concerns about their medications compared with those with high adherence.
• Systemic disease activity remained low and stable in both groups, with no significant differences in ESSDAI scores at baseline or follow-up; ESSPRI total scores also did not differ significantly between low- and high-adherence groups at baseline or follow-up.
• Psychological status, fatigue, functional ability, and quality of life were comparable between the adherence groups.
• Each one-point increase in the necessity-concern differential was associated with greater odds of being classified as high adherence (odds ratio, 1.95; 95% CI, 1.01-3.76).

IN PRACTICE

"Assessment of patients' perceived need for treatment and medication-related concerns may help clinicians identify individuals who could benefit from more detailed treatment discussions," wrote the authors.

SOURCE

The study was led by Kemal Erol, Selçuk University in Konya, Türkiye. It was published online on August 22 in Rheumatology International.

LIMITATIONS

The sample size was relatively small, particularly after loss to follow-up, which may have limited statistical power. Medication adherence was assessed using a self-report instrument, which may be subject to recall and social desirability bias. Adherence and medication beliefs were measured at the same timepoint, precluding causal interpretation.

DISCLOSURES

Open access funding was provided by the Scientific and Technological Research Council of Türkiye. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.