Prednisolone non-compliance and its related factors in patients with systemic lupus erythematosus

The combination of western medicine and traditional Chinese medicine is still exerting a pervading influence on symptom relief in Chinese society. The Medical behavior pattern may influence medication non-compliance by patients with chronic illness.

The study was designed to investigate prednisolone non-compliance and its related factors for patients with systemic lupus erythematosus (SLE) under giving patients' health beliefs, the influence of prednisolone and Chinese culture. All patients of the SLE Mutual Aid Group (N=570) participated in this study. A questionnaire which included medical behavior and individual attitudes was sent each by mail. The response rate was 63.7% (N=363); 329 responses were useable in the study.

Of the 329 patients, 27.9% had taken traditional medicine or a combination of traditional medicine with western medicine within the past month; 25.4% patients were non-compliant with prescribed prednisolone during the past week. The important reasons for non-compliance were feeling better, fearing side effects and treatment by Chinese medicine. The predicting factors for prednisolone non-compliance were the effects of the prednisolone, medical feasibility, patterns of medical behavior and perceived seriousness of the disease. Physician-patient relationship served as modifying factors which influenced individual attitudes toward prednisolone non-compliance and choice of medical behavior. Traditional beliefs, influenced by Chinese culture, indirectly affected prednisolone non-compliance, but through medical behavior patterns.

Predisolone non-compliance is quite essential for SLE patients. Findings suggested that the attributes of prednisolone and the influences of Chinese traditional medicine should be considered as well as a health belief model, when trying to improve prednisolone compliance for SLE patients in Taiwan society.