B39-02 Beyond Access: How Self-Efficacy and Care Experience Shape Medication Adherence in Sarcoidosis

Abstract Rationale Patients with sarcoidosis frequently report challenges following prescribed medication regimens. In our qualitative work, patients reported that medication adherence was driven primarily by perceived lack of efficacy and concern for side effects rather than challenges in access to medication. We aimed to evaluate how patient-reported quality of care, medication side effects, and demographic and financial factors relate to medication adherence among participants in the Foundation for Sarcoidosis Research (FSR) Patient Registry. Methods We surveyed members of the FSR Patient Registry, which collects patient-reported data on demographics, disease characteristics, and treatment at baseline and annually. In collaboration with the FSR, we invited registry participants to complete several existing instruments: Medication Adherence Report Scale-5 (MARS-5), Assessment of Care for Chronic Conditions (ACCC), Perceived Stress Scale (PSS), King’s Sarcoidosis Questionnaire-Medication domain (KSQ-M), Patient Health Questionnaire (PHQ-8), Sarcoidosis Assessment Tool-Fatigue (SAT-F), and PROMIS Self-Efficacy for Managing Chronic Conditions-Symptoms (SECC-S). The primary outcome was MARS-5 score, and the primary predictor was ACCC score. We also examined associations between MARS-5 and indicators of financial status (insurance, income, and self-reported financial impact of sarcoidosis). Univariable and multivariable negative binomial models were used to identify predictors of adherence. Results Of nearly 7,000 patients invited, 506 completed the survey; 368 completed the MARS-5 questions (primary outcome) and were included in analyses. In univariable analyses, higher adherence (MARS-5) was associated with higher patient-reported quality of care (ACCC) and greater self-efficacy for symptom management (SECC-S). Lower adherence was associated with greater fatigue (SAT-F), depressive symptoms (PHQ-8), and perceived stress (PSS). In variable selection analyses, self-efficacy emerged as the strongest predictor of adherence Conclusions Among patients with sarcoidosis, perceived quality of care, mental health, fatigue, and self-efficacy appear to influence medication adherence more strongly than financial factors. These findings suggest that enhancing self-efficacy and improving patient-centered care may be key strategies for supporting adherence. This abstract is funded by: NIMHD