Drug Compliance in Children with Juvenile Idiopathic Arthritis and Reasons for Poor Compliance

Mohammad Humayun Kabir

doi:10.11648/j.ajcem.20170501.14

Abstract

Children with chronic disorders are at risk for a higher medication non-adherence. Juvenile idiopathic arthritis (JIA) is a chronic childhood disorder where often medication non-adherence is an issue. The purpose of this study was to assess drug compliance of JIA patients,to find out the proportion of patients having poor drug compliance and to find out possible reasons of poor drug compliance. This was a retrospective study conducted in the Pediatric Rheumatology follow up clinic, Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. All JIA patients attending pediatric rheumatology follow up clinic during the study period was included. Data were collected using a structured questionnaire. Among the total 900 registered JIA cases, 116(12.9%) patients had poor compliance. Among 116 poor compliant patients, systemic onset JIA cases were the highest (34.5%), followed by enthesitis related arthritis (30.2%). Among the poor compliant patients, 6.9% patients had regular follow up and 93.1% had irregular follow up. Major reasons of poor compliance were financial crisis, lack of awareness and difficulty in transportation. Poor compliance to treatment of JIA in our setting was common. The most important reason for poor compliance was financial crisis.

Highlights

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and one of the common chronic illnesses of childhood
The study included children with JIA who met the classification criteria set by the International League of Association for Rheumatology (ILAR) attending Paediatric Rheumatology follow up clinic, who have completed at least 1 year of treatment
Systemic onset JIA cases were the highest (4.44%) among the cases followed by enthesitis related arthritis (3.88%)

Summary

Introduction

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and one of the common chronic illnesses of childhood. The treatment of JIA in children is complex & challenging. Medical treatment of JIA includes NSAIDs, DMARDs, Corticosteroids, Biological agents and other supportive drugs [1]. Duration of treatment of JIA is usually long and needs regular follow up and good compliance for clinical remission. According to the World Health Organization, drug compliance can be defined as the degree of agreement between the patient's behavior-taking medication, following a diet or implementing lifestyle changes-and the recommendations from a health care provider [2]. The term "good compliance" is used when there is regular use of more than 80% of medications and other prescribed treatment modalities [3]. The present study assessed the proportion of JIA patients having poor drug compliance and possible reasons of poor drug compliance

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Discussion

Conclusion