Therapeutic Compliance in Patients Followed for Lupus and Rheumatoid Arthritis in Niamey (Niger): Multicenter Study

Abstract

Introduction: Like all chronic diseases, Autoimmune diseases (AID) require long-term, even lifelong, medication. Their progression and prognosis depend on adherence to these therapies, which are often fraught with side effects. We conducted a study on the adherence of patients being treated for systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). Method : Our study was prospective, descriptive and analytical, lasting 3 months from May 20, 2024, to August 20, 2024, in the 3 reference hospitals of Niamey. Results : A total of 27 patients were included, representing 30% of the patients with lupus and/or rheumatoid arthritis collected. The age group over 35 years was the most represented, with a frequency of 74.1% (n = 20) and a female predominance of 92.60% (n = 25). Prednisone and hydroxychloroquine were the most used molecules, 70.4% each, followed by methotrexate at 22.2%. Low adherence predominated, followed by medium adherence and high adherence in 67% (n = 18), 26% (n = 7) and 7% (n = 2) respectively. Adherence to antimalarials was the lowest, followed by glucocorticoids and immunosuppressants in 51.9% (n = 14), 48.1% (n = 13) and 25.9% (n = 7). Patients with SLE had lower adherence at 44.4% (n = 12). The major barriers to treatment adherence reported by our patients were weariness, forgetfulness, fear of side effects and low socioeconomic level in 51.9% (n = 14), 48.1% (n = 13), 40.7% (n = 11) and 29.6% (n = 8), respectively. Conclusion : It is important that physicians adopt a prescribing strategy that focuses on limiting themselves to the essentials, prioritizing single-dose molecules and fixed combinations if necessary.