Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis

Area of Science:

• Pediatric Rheumatology
• Pharmacology
• Health Services Research

Background:

• Juvenile rheumatoid arthritis (JRA) is a chronic condition requiring long-term medication adherence.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed for JRA symptom management.
• Understanding adherence patterns is crucial for optimizing treatment outcomes in pediatric populations.

Purpose of the Study:

• To characterize adherence rates to NSAIDs in newly diagnosed JRA patients.
• To identify demographic and disease-related factors predicting NSAID adherence.
• To inform targeted interventions for improving medication adherence in JRA.

Main Methods:

• Prospective monitoring of NSAID adherence in 48 children with JRA over 28 days using electronic devices.
• Assessment of disease activity including active joint counts and morning stiffness.
• Collection of demographic data: age, sex, ethnicity, and socioeconomic status.

Main Results:

• 52% of patients met an 80% adherence threshold; 48% were nonadherent.
• Significant predictors of adherence included higher active joint counts and higher socioeconomic status.
• A logistic regression model achieved 70.5% correct classification of adherent/nonadherent patients.

Conclusions:

• Adherence to NSAIDs in JRA appears to be symptom-driven, with more active joints correlating with better adherence.
• Higher socioeconomic status is associated with improved adherence, highlighting potential disparities.
• Families with lower socioeconomic status may require additional support to ensure medication adherence.