CHEST Guidelines-Causes-of-Poor-Medication-Adherence-in-Sarcoidosis (1)

Causes-of-Poor-Medication-Adherence-in-Sarcoidosis (1)

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Medication nonadherence is a significant challenge in managing sarcoidosis, with a study showing that 66% of patients in a university clinic exhibited nonadherent behavior. The term "adherence" is preferred over "compliance" as it reflects a partnership between patient and physician. Adherence is often suboptimal, especially in chronic conditions, leading to stigmatization. Numerous factors contribute to nonadherence: cognitive issues, forgetfulness, psychosocial problems, the chronic nature of the disease, doubts about treatment efficacy, medication side effects, complex regimens, lack of patient insight, and medication costs. However, poor communication between patients and clinicians is a key overarching issue.<br /><br />For corticosteroid therapy, which is common in sarcoidosis, nonadherence is often due to side effects like weight gain, epigastric pain, and dissatisfaction with doctor-patient relations. Corticosteroids are usually effective and inexpensive, but their side effects and lack of evidence for curing sarcoidosis or altering its progression lead patients to question their prolonged use.<br /><br />The editorial highlights the crucial role of establishing improved communication between clinicians and patients to address these adherence issues. It suggests reconsideration of the current reliance on corticosteroids for initial and maintenance therapy in sarcoidosis. Exploring noncorticosteroid alternatives could potentially align treatment plans more closely with patient preferences and improve overall adherence and outcomes in sarcoidosis care. African Americans demonstrated lower adherence than white patients, a previously unobserved trend in other conditions, suggesting the need for tailored approaches to improve adherence across different patient demographics.

Keywords

medication nonadherence

sarcoidosis management

patient adherence

corticosteroid therapy

doctor-patient communication

chronic disease

treatment side effects

noncorticosteroid alternatives

patient demographics

African American adherence