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The effect of patient compliance on remission rates in pediatric noninfectious uveitis
Noy Ashkenazy1, Ujwala S Saboo2, Zachary M Robertson3
1University of Texas Southwestern Medical Center, Dallas; Children's Medical Center Dallas, Dallas, Texas.
Insights
Compliance barriers in pediatric noninfectious uveitis negatively impact steroid-free remission rates. Addressing these challenges is crucial for improving treatment outcomes in children with this condition.
Area of Science:
- Ophthalmology
- Pediatrics
- Immunology
Background:
- Pediatric noninfectious uveitis requires long-term management with immunomodulatory therapy.
- Compliance with complex treatment regimens can be challenging for pediatric patients and their families.
- Achieving steroid-free remission is a key goal in managing noninfectious uveitis.
Purpose of the Study:
- To identify barriers to treatment compliance in pediatric patients with noninfectious uveitis.
- To evaluate the association between compliance barriers and the achievement of steroid-free remission.
Main Methods:
- Retrospective analysis of pediatric patients with noninfectious uveitis treated between September 2015 and March 2017.
- Identification of compliance barriers and calculation of steroid-free remission rates.
- Statistical analysis to determine the association between compliance and remission.
Main Results:
- 58% of 57 pediatric patients were compliant with immunomodulatory therapy.
- Barriers included complex regimens (>3 medications), negligence, transportation, family issues, and systemic autoimmune diseases.
- Poor compliance was linked to significantly lower steroid-free remission rates (21% vs 79%).
Conclusions:
- Noncompliant pediatric patients with noninfectious uveitis have a lower likelihood of achieving steroid-free remission.
- Addressing identified compliance barriers may improve treatment outcomes.
- Compliance is a critical factor in managing pediatric noninfectious uveitis.
Purpose:
To identify barriers to compliance in pediatric noninfectious uveitis, and to examine its association with achieving steroid-free remission.
Methods:
A retrospective analysis was performed on pediatric patients with noninfectious uveitis on immunomodulatory therapy treated at the University of Texas Southwestern Medical School and Children's Medical Center (Dallas, TX) between September 2015 and March 2017. Compliance barriers were identified and rates of achieving steroid-free remission were calculated.
Results:
A total of 57 patients with noninfectious uveitis requiring immunosuppressive therapy met inclusion criteria. Thirty-three (58%) of patients were compliant. Notable barriers to compliance included regimens requiring >3 medications, patient/parent negligence, transportation issues, family strife, and presence of an associated systemic autoimmune disease (P < 0.050). At a median follow-up of 24 months, a total of 28 (49%) achieved steroid-free remission. The presence of 3 or more compliance barriers was associated with decreased remission rates (P < 0.050). Poor compliance was associated with decreased rates of steroid-free remission (21% vs 79% [P = 0.002]).
Conclusions:
Noncompliant patients with noninfectious pediatric uveitis requiring immunomodulatory therapy were found to have a lower rate of achieving steroid-free remission compared to patients who exhibited full compliance.
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