Medication Beliefs, Adherence Rates in Systemic Lupus Erythematosus Differ by Race


Non-White patients were more likely to express beliefs that medications are both harmful and overused, leading to a decrease in medication adherence.

Medication adherence interventions tailored to patient race may help increase adherence among non-White patients, according to research results presented at ACR Convergence 2021, the annual meeting of the American College of Rheumatology.1

Because racial differences in patient beliefs about medications have not been well explored, researchers sought to determine the differences in medication belief, and subsequent association with medication adherence, between White and non-White patients with systemic lupus erythematosus (SLE).

A total of 102 patients—48 White, 48 Black, 5 Asian, and 1 Hispanic—who met the American College of Rheumatology or SLICC SLE criteria completed the Beliefs about Medicines Questionnaire. Researchers compared median scores between White and non-White patients, then explored the relationship between questionnaire score and medication adherence.

Mean age of participants was 50 years, with 96% women in the cohort. Thirty-three percent of patients had a college education, and 54% reported having private insurance.

Across a total of 18 questions, responses to 11 questions produced answers that statistically differed between White and non-White patients; in general, non-White patients held more beliefs that medications are both harmful and overused (8.5 vs 7 and 11 vs 8.5, respectively). Overall, 71% of White patients reported adhering to their treatment regimen, compared with 44% of non-White patients. White patients who were nonadherent reported more concerns specific to their SLE medication.

“These results suggest [that] adherence interventions tailored to race may be more effective, with a focus on building trust in the non-White community,” the researchers concluded. “Future studies should investigate the relationship between medication beliefs and SLE outcomes.”

“The extent to which racial differences in medication beliefs may be driven by mistrust in the medical system and systematic racism also deserve further study,” they added.


  1. Anderson DR, Eudy A, Clowse M, et al. Racial differences in medication beliefs among SLE patients. Presented at: ACR Convergence 2021; November 3-9, 2021. Abstract 601.
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