Study of Adherence to Medication in Pediatric Liver Diseases (“SAMPLD” Study) in Indian Children

Abstract

Adherence to medication(s) is an essential component of holistic management in any chronic disease including in post liver transplant (LT) patients. Thus, this study aimed to assess adherence to medications in Indian pediatric liver disease patients (including post LT recipients) and to identify variables affecting its occurrence. A cross-sectional study was conducted amongpediatric (<18 years of age) subjects with Wilson disease (WD) and autoimmune liver disease (AILD) along with post LTrecipients from May 2021 to October 2021. Structured tools using prevalidated questionnaires (Medication adherence measureand the Child & Adolescent Adherence to Medication Questionnaire) were used to collect data related to nonadherence prevalence (based on missed and late doses) and factors influencing the adherence. A total of 152 children were included in the study (WD 39.5%, AILD 32.9%, and post LT 27.6%). Prevalence of missed and late dose nonadherence (at a cut-off of ≥20%) was 12.5% and 16.4%, respectively. Older age (odd's ratio/O.R 1.185), stay in a rural area (O.R 5.08), and barriers like bad taste of medication(O.R 4.728) and hard to remember the medication(O.R 7.180) were independently associated with nonadherence (P<0.05). Overall, nonadherence was seen in 12-16%, i.e., around one-sixth of the patients, with least nonadherence seen in post LT recipients (0-2.4%). Older age of the patient, rural place of stay and personal barriers like hard to remember/forgetfulness and bad medication taste were identified as factors independently leading to nonadherence.