Article Text
Abstract
Background Ankylosing spondylitis (AS) is a chronic, progressive, inflammatory disease which can cause labour loss and deformities and requiring long-term treatment. Loneliness, perceived social support, depression, patients‘ beliefs about medicines and treatment may affect their medication adherence and treatment success.
Objectives In this study, we aimed to investigate the relationship between loneliness, perceived social support, depression and medication adherence in AS patients.
Methods This cross-sectional study was conducted in a tertiary rheumatology outpatient clinic. One hundred and nineteen AS patients were enrolled to the study. The socio-demographic and clinical features of the patients agreeing to participate were recorded to the “Patient Assessment Form”. The patients‘ disease activity and functional status were determined with the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI, and the Bath Ankylosing Spondylitis Functional Index (BASFI), respectively. The pain and global assessment of the patients‘ were assessed with a numerical visual analogue scale (nVAS; 0–10 cm). The medication adherence of the patients was assessed with the Morisky Green Levine Scale (MGLS). The UCLA Loneliness Scale, the Multidimensional Scale of Perceived Social Support (MSPSS) and the Beck Depression Inventory (BDI) were used to determine loneliness, perceived social support, and depression of the patients.
Results One hundred five patients (88.2%) were male, the mean age was 35.80±9.08 years, and the mean disease duration was 9.88±6.34 years. The mean BASDAI, BASFI and patient global assessment scores were; 4.57±2.63, 3.23±2.76, and 4.13±3.23, respectively. According to the MGLS medication adherence groups, patients with low medication adherence had higher BASDAI, spinal pain, spinal pain at night, fatigue and patient global assessment scores and had lower mean ages (p<0.05). Among the MGLS medication adherence groups, patients with low medication adherence had lower MSPSS scores, and had higher UCLA Loneliness Scale and Beck Depression Inventory scores (p=0.037, p<0.001, p=0.022, respectively) (table 1).
Comparison of the perceived social support, depression and loneliness scores with the Morisky Green Levine Scale subgroups.
Conclusions In this study, it was shown that as the average age and social support scores of patients decreased, and as the BASDAI, spinal pain, spinal pain at night, fatigue, patient global assessment, loneliness and depression scores increased, adherence to treatment were decreased. It is thought that patients should be handled holistically in terms of biopsychosocial aspect in order to improve adherence to medical treatment.
Disclosure of Interest None declared