Background: Medication adherence (MA) in lupus patients is essential for improving disease prognosis [1]. Life satisfaction (LS), a component of subjective well-being, evaluates one’s life according to personal criteria, compares current circumstances with idealized ones, and is a long-term, enduring assessment. It is associated with health outcomes, including mortality [2, 3, 4, 5].

Objectives: The present study aims to investigate the association between LS and MA in patients with systemic lupus erythematosus (SLE).

Methods: This cross-sectional study is part of a cohort study (Longitudinal Study in Systemic Lupus Erythematosus- ELLES), which follows adult SLE patients in a Rheumatology unit of a University Hospital in Brazil. Data collected between 2019 and 2024 was used to analyze the association between LS and MA. LS, the exposure variable, was assessed by the Satisfaction With Life Scale, which consists of five items individually ranked on seven-point Likert scales [6]. The total score ranged from five to 35 points, with higher scores indicating higher levels of LS [6]. MA, the dependent variable, was assessed in two ways: (1) ELLES-question (“ Did you take the medications as prescribed? ”), “Yes” answer is considered adherent; (2) using the 8-item Morisky Medication Adherence Scale (MMAS-8) [7]. The higher the MMAS-8, the worse the MA. In this study, we categorize patients into three groups: high adherence (reference - <50th percentile), medium adherence (50th≥ percentile <75th), and low adherence (≥75th percentile). The association of LS (continuous scale) and MA was investigated using logistic or multinomial regressions, presented as Odds Ratios (OR) and 95% confidence intervals (CI), adjusting for sociodemographic (age, sex, skin color, education, marital status) and clinical factors (disease activity measure by modified SLEDAI-2k, without serologic items, and disease duration).

Results: The study included 308 patients, 93.2% women, with a median (interquartile range-IQR) age of 43 (35-53) years, 51.3% brown skin color, 53.3% married, 47.1% with high school education. Table 1 describes the distribution and prevalence of LES characteristics and LS of the total sample and according to MA. Higher LS was associated with the presence of MA according to ELLES-question, even after adjustments (OR:1.19; CI 1.07-1.32). Higher LS also decreased the likelihood of low MA based in MMAS-8 after adjustments (OR:0.94; CI 0.90-0.98); namely, a one-point increase on the life satisfaction scale is associated with a 6% decrease in the chance of low adherence (Table 2).

Conclusion: High LS was associated with better MA in adult SLE patients, suggesting that adding the subjective well-being evaluation to our routine clinical practice can help us understand this important dimension of lupus patient’s prognosis. The follow-up of the participants will allow for testing of the hypothesis that LS is a protective factor for better MA in SLE patients.

REFERENCES: [1] Alsowaida N et al. Lupus. 2018; 27(2):327-332.

[2] Diener E et al. Appl Pyschol: Health and Well-Being. 2017; 9 (2): 133-167.

[3] Azevedo DC et al. J Clin Rheumatol. 2021;27(6S): S301-S307.

[4] Okely JA, Gale CR. Psychosom Med. 2016;78(3):335-44.

[5] Chida Y, Steptoe A. Psychosom Med. 2008;70(7):741–56.

[6] Diener E et al. J Pers Assess. 1985; 49:71–75.

[7] Morisky DE et al. J Clin Hypertens. 2008;10(5):348-54.

Acknowledgements: NIL.

Disclosure of Interests: Vítor Hugo de Souza Barbosa: None declared , Lara Machado Sousa Castro: None declared , João Vitor Pereira Reis: None declared , Ana Luiza Pereira Bitencourt Silva: None declared , Bianca Laís Borges Nogueira: None declared , Alejandro Aleixo Molina: None declared , Gabriel Solgon da Silva Lisboa: None declared , Isabela Pereira Rios: None declared , Marcus Vinicius Miranda Macedo: None declared , Victor Bottrel Lopes de Moura: None declared , CRISTINA COSTA LANNA Advisory Board of Lupus Nephritis, Roche, Fabiana Moura Janssen and GSK, ROSA WEISS TELLES: None declared , Daniela Castelo Azevedo: None declared.

© The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ ). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.