Background Glucocorticoids (GC) are widely used in the management of chronic inflammatory diseases. However, lack of patients’ adherence leads to suboptimal effectiveness of GC therapy in real-life practice

Purpose The aim of this study is to identify factors which may lead to non adherence to oral GC in the treatment of chronic inflammatory diseases.

Material and methods Cross-sectional study included outpatients and inpatients in an internal medicine department. Patients who had been taking oral GC for more than 3 months prior to the study were enrolled. Adherence was measured using patient self-reports. Bivariate methods were used for analysis.

Results Ninety-seven patients (sex ratio=0.18), with a mean  ±SD age of 51±13 years were enrolled. Patients interviewed were under GC therapy since an average of 7.71±5.75 years. The median daily GC dose was 16.35 mg (all patients were treated with prednisone). Fifty-three patients (55%) had poor adherence to GC. Major causes reported were occurrence of an adverse event, forgetfulness and a high number of pills respectively in 28, 24 and 13 patients. Female sex (p=0.032) and age greater than 40 years (p<0.000) were correlated to poor adherence. No relation had been demonstrated between adherence and maritial status (p=0. 215), regular activities (p=0.388), education level (p=0.181), length of treatment (p=0.95) and number of pills (p=0.439). In addition, this study revealed a problem with GC overuse in 20 patients. The reasons were symptom reduction, lack of information, distance follow-up appointments and easy access to GC from free-practice pharmacies.

Conclusion The results showed poor adherence in patients under GC. The occurrence of an adverse event was the main reason for non-adherence. Thus the setting-up of a therapeutic patient education programme would improve patient adherence and therefore quality and safety of GC therapy.

No conflict of interest