Perceived adherence to prescribed treatment in juvenile idiopathic arthritis over a one-year period

Authors

  • Debbie Ehrmann Feldman,

    Corresponding author
    1. Université de Montréal, Montreal Children's Hospital, McGill University Health Centre, McGill University, and the Direction de la Santé Publique de Montréal, Montreal, Quebec, Canada
    • Université de Montréal, Faculté de médecine, École de Réadaptation, Canada Post 6128, Succursale Centre-ville, Montréal, Quebec, Canada H3C 3J7
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  • Mirella de Civita,

    1. McGill University and the Montreal General Hospital, Montreal, Quebec, Canada
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  • Patricia L. Dobkin,

    1. McGill University and the Montreal General Hospital, Montreal, Quebec, Canada
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  • Pete Malleson,

    1. British Columbia's Children's Hospital and the University of British Columbia, Vancouver, British Columbia, Canada
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  • Garbis Meshefedjian,

    1. Direction de la Santé Publique de Montréal, Montreal, Quebec, Canada
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    • Dr. Meshefedjian has received consulting fees (less than $10,000) from the Montreal General Hospital Research Institute of McGill University Health Center.

  • CiarÁn M. Duffy

    1. Montreal Children's Hospital and the McGill University Health Centre, McGill University, Montreal, Quebec, Canada
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Abstract

Objective

To document perceived adherence to treatment (taking medications and performing exercises) in patients with juvenile idiopathic arthritis (JIA) over a 1-year period and to identify related factors.

Methods

We surveyed parents of patients with JIA at the Montreal Children's Hospital and British Columbia's Children's Hospital in Vancouver. Parents were asked to respond to a series of questionnaires every 3 months over a 12-month period. Perceived adherence was evaluated on a 100-mm visual analog scale (VAS) in the Parent Adherence Report Questionnaire (PARQ). Parental coping, distress, child function, disease severity and duration, perceived helpfulness of treatment, problems encountered, and sociodemographic data were also assessed.

Results

The mean age of our sample of 175 children was 10.2 years; mean age at diagnosis was 6.1 years and mean disease duration was 4.1 years. Perceived adherence to medications was consistently high, with average adherence at baseline, 3, 6, 9, and 12 months being 86.1, 91.7, 90.4, 92.0, and 88.8, respectively, on the PARQ VAS. Perceived adherence to exercise was lower but remained steady, with corresponding means of 54.5, 64.1, 61.2, 63.0, and 54.3, respectively. Using generalized estimating equation analysis, factors associated with higher perceived adherence to medications included perceived helpfulness of medications and lower disease severity; those associated with higher perceived adherence to exercise were younger age of the child, child involvement in responsibility for treatment, and higher perceived helpfulness of the treatment.

Conclusion

Belief in helpfulness of treatment is associated with higher parental perceived adherence to treatment.

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