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Comparison between children with juvenile idiopathic arthritis and their parents concerning perceived treatment
Karine Toupin April1, Debbie Ehrmann Feldman, Robert W Platt
1Université de Montréal, Montreal, Quebec, Canada.
Insights
Parent and child agreement on treatment adherence in juvenile idiopathic arthritis (JIA) was moderate, with better concordance for exercise regimens than for medications. Understanding these perceptions is key for improving JIA management.
Area of Science:
- Pediatrics
- Rheumatology
- Adolescent Health
Background:
- Treatment adherence is crucial for managing juvenile idiopathic arthritis (JIA) and achieving optimal patient outcomes.
- Discrepancies between children's and parents' perceptions of adherence can impact treatment effectiveness.
- Understanding these differing viewpoints is essential for clinicians to provide tailored support.
Purpose of the Study:
- To assess the level of agreement between children with JIA and their parents regarding the child's adherence to treatment.
- To compare perceptions of adherence to both medication and exercise regimens between pediatric patients and their caregivers.
Main Methods:
- A study involving 50 children with JIA and their parents was conducted at a specialized JIA clinic.
- Participants completed separate adherence questionnaires assessing medication and exercise compliance.
- Statistical analyses included paired t-tests and intraclass correlation coefficients (ICCs) to evaluate agreement.
Main Results:
- Parents reported higher levels of negative reactions and perceived difficulty with treatment compared to children.
- Intraclass correlation coefficients indicated moderate agreement for overall adherence (medication: 0.32, exercise: 0.77).
- Agreement was generally better for exercise adherence and perceived difficulty than for medication adherence and perceived helpfulness.
Conclusions:
- Parent-child agreement on treatment adherence in JIA is, at best, moderate.
- Adherence perception concordance is notably higher for exercise programs than for prescribed medications.
- Addressing divergent perceptions is vital for enhancing JIA treatment adherence and outcomes.
Objective:
Adherence to treatment in juvenile idiopathic arthritis (JIA) may be associated with better outcomes. Clinicians must be aware of possible divergence between parents and children regarding adherence, in order to gain a better understanding of adherence and factors associated with it. The objective was to determine the level of agreement between children with JIA and their parents concerning perception of the child's adherence to the treatment regimen (for both medications and exercises).
Methods:
Fifty patients and their parents, who attended the JIA clinic at the Montreal Children's Hospital, completed the Child Adherence Report Questionnaire and the Parent Adherence Report Questionnaire. Paired t-tests were used to compare parents' and children's scores for adherence questions and agreements were analyzed by intraclass correlation coefficients (ICCs).
Results:
Parents reported that their children showed more negative reactions to taking medication and doing exercises, more helpfulness from the medication, and more difficulty to carry out the exercise program than their children reported. ICCs (95% confidence interval) for medications and exercises were, respectively, 0.32 (0.04, 0.56) and 0.77 (0.61, 0.87) for overall adherence, 0.33 (0.05, 0.57) and 0.39 (0.09, 0.62) for perceived difficulty to following treatment, and 0.37 (0.09, 0.60) and 0.45 (0.17, 0.67) for how often children had negative reactions following treatment. Levels of agreement for perceived helpfulness of treatments were quite low.
Conclusion:
Agreement between parents and children concerning adherence was at best moderate, and generally better for the exercise program than for prescribed medications.