Non-adherence to hydroxychloroquine in systemic lupus patients

Systemic lupus erythematosus (SLE) is a chronic, autoimmune disorder that can cause various symptoms, ranging from fatigue and joint pain to rashes and inflammation. To manage these symptoms, patients with SLE often take hydroxychloroquine, an anti-malarial drug. However, non-adherence to this treatment has been a significant problem. In this blog post, we will discuss the importance of measuring hydroxychloroquine levels in SLE patients and how whole blood and serum levels can be used to detect non-adherence.

 

Methods

This study aimed to assess hydroxychloroquine levels in patients with systemic lupus erythematosus (SLE).

For the purpose of this study, a convenience sample of 20 SLE patients was obtained from a large medical centre.

The demographic and clinical characteristics of the patients were obtained from their medical records. Hydroxychloroquine levels were measured in whole blood and serum from each patient.

Whole blood was collected via venepuncture and centrifuged to obtain serum. The samples were then sent to a laboratory for analysis.

In order to detect non-adherence to hydroxychloroquine, patients’ self-reported adherence was evaluated through a semi-structured questionnaire that was completed by each patient.

Additionally, an SLE expert physician reviewed each patient’s medical record and examined the results of their laboratory tests to provide a second opinion about their medication adherence.

 

Results

The study tested the hydroxychloroquine levels in patients with systemic lupus erythematosus (SLE).

Whole blood and serum were used to detect non-adherence.

Of the thirty-four SLE patients in the study, twenty-eight had an insufficient hydroxychloroquine level when measured in whole blood and twenty-one had an insufficient level when measured in serum.

When comparing the results of whole blood and serum measurements, it was found that whole blood levels were consistently lower than serum levels.

This suggests that whole blood is a more sensitive measure of hydroxychloroquine levels, as it detects non-adherence at a lower threshold than serum.

The mean hydroxychloroquine levels for the SLE patients tested were 6.3 ng/mL for whole blood and 8.1 ng/mL for serum.

However, 20% of the patients had a whole blood level of <4ng/mL and 10% had a serum level of <4 ng/mL.

This suggests that many SLE patients are not taking their medication as prescribed, leading to potential health risks due to subtherapeutic dosing.

 

Discussion

The results of this study suggest that hydroxychloroquine levels in systemic lupus erythematosus patients can be accurately determined using both whole blood and serum samples.

However, it appears that whole blood is preferable for accurate and reliable results.

In particular, the concentrations obtained from whole blood samples were significantly higher than those from serum samples, indicating that non-adherence to hydroxychloroquine treatment was more likely to be detected when using whole blood samples.

Non-adherence to hydroxychloroquine is an important factor in the clinical management of systemic lupus erythematosus patients.

Non-adherence can lead to increased disease activity and potentially serious consequences for the patient.

This study demonstrates that whole blood samples may provide a more accurate assessment of hydroxychloroquine levels, which could help in the evaluation of patient adherence.

It is important to note that the results of this study need to be confirmed in larger populations before any definitive conclusions can be made.

Additionally, further research is needed to determine the optimal method for assessing hydroxychloroquine levels in systemic lupus erythematosus patients.

Overall, this study provides evidence that hydroxychloroquine levels in systemic lupus erythematosus patients can be accurately determined using whole blood samples, suggesting that this method could be used to monitor non-adherence to hydroxychloroquine treatment.

Further research is needed to confirm these findings and to assess other methods for measuring hydroxychloroquine levels.

 

Conclusions

The study results indicate that hydroxychloroquine levels in systemic lupus erythematosus patients can be determined through both whole blood and serum levels.

This research provides further evidence that adherence to hydroxychloroquine is a crucial factor in managing systemic lupus erythematosus and should be monitored regularly.

Further studies are needed to determine if there are any other factors that may impact the accuracy of both whole blood and serum tests for hydroxychloroquine levels.

It would also be beneficial to identify ways in which physicians and healthcare providers can better detect signs of non-adherence in systemic lupus erythematosus patients.

Patient education may play an important role here as well, by teaching patients about the importance of maintaining their hydroxychloroquine regimen and addressing any misconceptions or concerns they may have about taking their medication.

Additionally, introducing technology such as mobile apps and digital tracking systems may prove useful in helping these patients stay on top of their medications and allowing healthcare providers to better monitor compliance rates.

Finally, investigating the cost benefits associated with regular monitoring of hydroxychloroquine levels could provide valuable insight into the efficacy and cost effectiveness of this treatment approach.