eprintid: 10054462 rev_number: 34 eprint_status: archive userid: 608 dir: disk0/10/05/44/62 datestamp: 2018-08-20 17:58:31 lastmod: 2021-09-17 22:39:19 status_changed: 2018-08-20 17:58:31 type: article metadata_visibility: show creators_name: Costedoat-Chalumeau, N creators_name: Houssiau, F creators_name: Izmirly, P creators_name: Le Guern, V creators_name: Navarra, S creators_name: Jolly, M creators_name: Ruiz-Irastorza, G creators_name: Baron, G creators_name: Hachulla, E creators_name: Agmon-Levin, N creators_name: Shoenfeld, Y creators_name: Dall'Ara, F creators_name: Buyon, J creators_name: Deligny, C creators_name: Cervera, R creators_name: Lazaro, E creators_name: Bezanahary, H creators_name: Leroux, G creators_name: Morel, N creators_name: Viallard, J-F creators_name: Pineau, C creators_name: Galicier, L creators_name: Van Vollenhoven, R creators_name: Tincani, A creators_name: Nguyen, H creators_name: Gondran, G creators_name: Zahr, N creators_name: Pouchot, J creators_name: Piette, J-C creators_name: Petri, M creators_name: Isenberg, D title: A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring SLE: Assessment by Drug Levels and Self‐Administered Questionnaires ispublished: pub divisions: UCL divisions: B02 divisions: C10 divisions: D17 divisions: G90 note: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions. - Note of Republication: The version of this article originally published online on 19/9/17 used the MMAS‐8 scale in Table 1 without full permission from Dr. Donald E. Morisky and co‐authors. All mentions of the MMAS‐8 scale have now been removed and the paper re-published online on 6/8/18. abstract: Nonadherence to treatment is a major cause of lupus flares. Hydroxychloroquine (HCQ), a major medication in systemic lupus erythematosus, has a long half‐life and can be quantified by high‐performance liquid chromatography. This international study evaluated nonadherence in 305 lupus patients with flares using drug levels (HCQ <200 ng/ml or undetectable desethylchloroquine), and self‐administered questionnaires (MASRI <80%). Drug levels defined 18.4% of the patients as severely nonadherent. In multivariate analyses, younger age, nonuse of steroids, higher body mass index, and unemployment were associated with nonadherence by drug level. Questionnaires classified 23.4% of patients as nonadherent. Correlations between adherence measured by questionnaires, drug level, and physician assessment were moderate. Both methods probably measured two different patterns of nonadherence: self‐administered questionnaires mostly captured relatively infrequently missed tablets, while drug levels identified severe nonadherence (i.e., interruption or erratic tablet intake). The frequency with which physicians miss nonadherence, together with underreporting by patients, suggests that therapeutic drug monitoring is useful in this setting. date: 2019-08 date_type: published official_url: https://doi.org/10.1002/cpt.1194 oa_status: green full_text_type: other language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1574622 lyricists_name: Isenberg, David lyricists_id: DAISE40 actors_name: Flynn, Bernadette actors_id: BFFLY94 actors_role: owner full_text_status: public publication: Clinical Pharmacology & Therapeutics volume: 106 number: 2 pagerange: 374-382 event_location: United States issn: 1532-6535 citation: Costedoat-Chalumeau, N; Houssiau, F; Izmirly, P; Le Guern, V; Navarra, S; Jolly, M; Ruiz-Irastorza, G; ... Isenberg, D; + view all <#> Costedoat-Chalumeau, N; Houssiau, F; Izmirly, P; Le Guern, V; Navarra, S; Jolly, M; Ruiz-Irastorza, G; Baron, G; Hachulla, E; Agmon-Levin, N; Shoenfeld, Y; Dall'Ara, F; Buyon, J; Deligny, C; Cervera, R; Lazaro, E; Bezanahary, H; Leroux, G; Morel, N; Viallard, J-F; Pineau, C; Galicier, L; Van Vollenhoven, R; Tincani, A; Nguyen, H; Gondran, G; Zahr, N; Pouchot, J; Piette, J-C; Petri, M; Isenberg, D; - view fewer <#> (2019) A Prospective International Study on Adherence to Treatment in 305 Patients With Flaring SLE: Assessment by Drug Levels and Self‐Administered Questionnaires. Clinical Pharmacology & Therapeutics , 106 (2) pp. 374-382. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10054462/1/Costedoat-Chalumeau_et_al-2018-Clinical_Pharmacology_%2526_Therapeutics.pdf