Intervention to Improve Patient-provider Communication and Medication Adherence Among Patients With Systemic Lupus Erythematosus (SLE)
Duke University
Summary
CO-LEAD is an intervention to improve patient-provider communication and medication adherence among patients with systemic lupus erythematosus (SLE). The purpose of this study is to optimize the culturally appropriate delivery and test the effect of the CO-LEAD intervention, which includes the following: 1. clinicians will be provided with a program to teach them to use effective communication strategies with patients to review real-time pharmacy refill date, engage and formulate solutions to adherence barriers, and collaboratively overcome adherence barriers. 2. use of a reliable and valid patient-reported measure of the extent of and reasons for nonadherence that helps patients identify and communicate their adherence barriers with clinicians proactively, efficiently, and comprehensively.
Description
Substantial racial disparities exist in patients with systemic lupus erythematosus (SLE), a disease that markedly reduces life expectancy and quality of life. Long-term, consistent use of immune-altering medicines is critical for treating symptoms and preventing organ damage from SLE, but Black patients have lower medication adherence. While reasons for nonadherence are complex, Black patients with SLE are disproportionately affected by motivational barriers related to their beliefs, attitudes, and trust. Effective and collaborative patient-clinician communication can lead to more honest excha…
Eligibility
- Age range
- 18–90 years
- Sex
- All
- Healthy volunteers
- No
Clinician Inclusion Criteria: 1. Adult rheumatology attendings, advanced practice providers, and fellows at the two academic institutions 2. Clinicians who have ambulatory rheumatology care at least ½ day per week Clinician Exclusion Criteria: 1. Clinicians at Duke University who were involved in the investigators' pilot work 2. Clinicians with an anticipated departure from the institution in the 12 months following enrollment Patient Inclusion Criteria: 1. 18 years or older 2. English-speaking, able to provide consent 3. Diagnosed with SLE and receiving care with enrolled clinicians 4. P…
Interventions
- BehavioralCO-LEAD
The investigators will provide clinicians with a program to teach them to use effective communication strategies with patients to review real-time pharmacy refill data and the DOSE-Nonadherence-SLE survey, and engage and formulate solutions to adherence barriers together. The study team will provide the clinician intervention training in-person or virtually and will include didactics, demonstration, and practice that include two one-hour sessions one month apart. After training, CO-LEAD clinicians will be encouraged to incorporate the intervention in regular clinic visits with all patients.
Location
- Duke UniversityDurham, North Carolina