MedPath

Lupus and Observance

Completed
Conditions
Systemic Lupus, Skin Lupus
Registration Number
NCT03019926
Lead Sponsor
University Hospital Center of Martinique
Brief Summary

A poor therapeutic observance is described between 3 and 76% cases in systemic lupus. It is associated with an increased risk of relapses, hospitalizations, morbidity and poor renal prognosis.

New treatment protocols exist and are indicated in second intention in case of good compliance. An assessment of therapeutic adherence is therefore essential.

Patients with systemic lupus diagnosed for at least 6 months, or skin lupus, who have been prescribed with Plaquenil (hydroxychloroquine), will be included in the study.

The study primary objective is to determine risk factors for non-observance

The secondary objectives are to:

* Measure the observance rate of patients with systemic lupus in Martinique.

* Describe the parameters that influence observance: evaluation of the disease and associated comorbidities, psychosocial assessment, assessment of the doctor-patient relationship, evaluation of the disease representations.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
200
Inclusion Criteria
  1. Age ≥ 18 years
  2. Systemic lupus defined according to the diagnostic criteria of the American College of Rheumatology " 1997, diagnosed for at least 6 months; Or Skin Lupus
  3. Consultation or hospitalization at the University Hospital of Martinique, in either services of Internal Medicine, Rheumatology or Dermatology.
  4. Prescription of hydroxychloroquine (Plaquenil®) for at least 6 months
  5. Affiliate or beneficiary of a social security scheme.
  6. Patient not opposed to participate in the study
Exclusion Criteria
  1. Age <18 years or patient under guardianship
  2. Patient not speaking and / or not understanding French
  3. No prescription and/or contraindication to hydroxychloroquine
  4. Systemic lupus outbreak with neurological impairment defined by SLEDAI score by a psychosis (disruption of normal activity in relation to a severe alteration of the perception of reality. Includes: hallucinations, incoherence, impoverishment of the content of thought, illogical reasoning, bizarre behavior, disorganized or catatonic) or brain damage (with impairment of mental functions with impaired orientation, memory or other brutal appearance and fluctuating evolution).
  5. History of psychiatric disorders: personality disorders, psychoses, severe depression
  6. Hospitalization with a life-threatening clinical condition that does not allow to answer questions
  7. Non affiliated patient or beneficiary of a social security scheme.
  8. Patient refusing to participate in the study

Study & Design

Study Type
OBSERVATIONAL
Study Design
Not specified
Primary Outcome Measures
NameTimeMethod
The primary outcome measure is based on a blood dosage of hydroxychloroquine (HCQ)Reflects the Plaquenil intake during the 40 previous days

The HCQ dosage is assayed on whole blood (6ml) by high-pressure liquid chromatography performance, reproducible and inexpensive method. Only one laboratory centralizes the sampling.

A dosage below 200 ng/ml or 0.2 mg/l defines a non-observing patient within the 40 days above.

Secondary Outcome Measures
NameTimeMethod
Patients considered as observing and non-observing will be compared according to the activity of the disease40 days

Activity of the disease : Systemic lupus considered as active for a SELENA-SLEDAI score ≥ 6

Patients considered as observing and non-observing will be compared according to number of prescribed medication40 days
Patients considered as observing and non-observing will be compared according to the presence of anxiety and/or depressive disorders40 days

Presence of anxiety and/or depressive disorders, according to the Hospital Anxiety And Depression Scale (HAD), a score \> to 10

Trial Locations

Locations (1)

CHU de Martinique

🇫🇷

Fort-de-France, Martinique, France

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