Abstract
ABSTRACTObjective: To develop a questionnaire that allows the early detection of patients at risk for poor adherence to medical and non-medical treatment in children and adolescents with chronic rheumatic diseases.Methods: The Pediatric Rheumatology Adherence Questionnaire (PRAQ) was applied in recently diagnosed patients within a period of one to four months after confirmation of the rheumatic disease. After six months, the patients’ adherence to the medical and non-medical treatment was assessed. An internal consistency analysis was conducted to eliminate redundant questions in the PRAQ.Results: A total of 33 patients were included in the pilot study. Six months after the PRAQ had been applied, poor global adherence was observed in seven (21.2%) patients and poor adherence to medical treatment in eight (24.2%) patients. No correlation was observed between the PRAQ scores and the percentages of adherence, as well as the stratification for each index, except for a tendency to a correlation between socioeconomic index and poor adherence to medical treatment (p=0.08). A new PRAQ questionnaire with 25 of the 46 original questions was generated as a result of the reliability analysis.Conclusions: The usefulness of this questionnaire in clinical practice should be still evaluated. Due to the importance of a tool for the early detection of rheumatic patients at risk of poor adherence to treatment, the new PRAQ questionnaire should be reviewed and applied in a larger study to better define its validity and reliability.
Highlights
Interest in the assessment of the adherence of children and adolescents to the treatment of chronic diseases has increased over the last three decades
This study proposed to develop a questionnaire that could allow the early detection of patients at risk for poor adherence to medical and non-medical treatment in children and adolescents with chronic rheumatic diseases, and several indexes were evaluated corresponding to adherence to medical and non-medical treatment
Regarding the indexes evaluated by the Pediatric Rheumatology Adherence Questionnaire (PRAQ) questionnaire, we found a tendency to a negative correlation between socioeconomic index and poor adherence to medical treatment
Summary
Interest in the assessment of the adherence of children and adolescents to the treatment of chronic diseases has increased over the last three decades. This is due to the harmful, costly, and irreversible effects that may occur in the case of treatment failure.[1,2]. Psychological, sociocultural, economic, and family-related factors are discussed.[1,3,4,5] The early detection of these issues for each individual suffering from a rheumatic disease contributes to the development of an effective strategy to promote adherence, improve the quality of life, and facilitate a longterm prognosis.[6,7]
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