Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis
Article first published online: 7 DEC 2005
Copyright © 2005 by the American College of Rheumatology
Arthritis Care & Research
Volume 53, Issue 6, pages 905–910, 15 December 2005
How to Cite
Rapoff, M. A., Belmont, J. M., Lindsley, C. B. and Olson, N. Y. (2005), Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis. Arthritis & Rheumatism, 53: 905–910. doi: 10.1002/art.21603
- Issue published online: 7 DEC 2005
- Article first published online: 7 DEC 2005
- Manuscript Accepted: 21 JUL 2005
- Manuscript Received: 25 MAY 2005
- Maternal and Child Health. Grant Number: MCJ-200617
- Juvenile rheumatoid arthritis;
- Nonsteroidal antiinflammatory drugs;
- Electronic monitoring
To describe patterns of adherence to nonsteroidal antiinflammatory drugs (NSAIDs) in newly diagnosed patients with juvenile rheumatoid arthritis (JRA), and to examine demographic and disease-related variables as potential predictors of adherence.
Adherence to NSAIDs was monitored in 48 children with JRA (mean age 8.6 years) over 28 consecutive days using an electronic monitoring device. Measures of disease activity (active joint counts, morning stiffness) and demographics (age, sex, ethnicity, socioeconomic status) were also obtained.
Using an 80% adherence cut point, 25 (52%) patients were classified as adherent and 23 (48%) as nonadherent. There was considerable variability across patients, with full adherence (taking all doses on time) ranging from 0 to 100% of the monitored days. Logistic regression showed that active joint count and socioeconomic status were the only significant predictors. Both were positively related to adherence. The model correctly classified 70.5% of patients as either adherent or nonadherent (Cox and Snell R2 = 0.295, P = 0.0005).
Children newly diagnosed with JRA are more likely to adhere to an NSAID regimen if they have a greater number of active joints or their families have higher socioeconomic status. The former finding suggests that children's adherence is symptom-driven, while the latter suggests that families of lower socioeconomic status deserve special attention to address adherence issues.