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[Prevalence and risk factors of medication non-adherence in children with inflammatory bowel disease]
1Department of Pharmacy, Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310051, China.
Insights
Medication non-adherence is common in pediatric inflammatory bowel disease (IBD). Older children, frequent dosing, and low parental knowledge increase non-adherence risk, impacting treatment outcomes.
Area of Science:
- Pediatric gastroenterology
- Chronic disease management
Context:
- Inflammatory bowel disease (IBD) significantly impacts children's quality of life and requires long-term management.
- Medication adherence is crucial for effective IBD treatment and preventing disease flares.
- Non-adherence in pediatric IBD can lead to suboptimal disease control and increased healthcare utilization.
Purpose:
- To determine the prevalence of medication non-adherence in children with IBD.
- To identify demographic and clinical risk factors associated with medication non-adherence in this population.
- To explore the role of parental disease-related knowledge in pediatric IBD medication adherence.
Summary:
- A cross-sectional study of 112 children with IBD found a 44.6% non-adherence rate.
- Risk factors for non-adherence included older age (7-18 years), medication taken twice or more daily, and lower parental disease-related knowledge.
- Parental knowledge about Crohn's disease and ulcerative colitis was inversely associated with non-adherence.
Impact:
- Findings highlight the need for targeted interventions to improve medication adherence in pediatric IBD.
- Healthcare providers should assess adherence barriers, particularly in older children and those with complex medication regimens.
- Enhancing parental education on IBD and its management is essential for improving treatment outcomes.
Abstract:
Objective: To investigate the prevalence and risk factors of medication non-adherence in children with inflammatory bowel disease (IBD). Methods: A cross-sectional study was conducted in Children's Hospital, Zhejiang University School of Medicine from September 2020 to March 2022 and 112 children with IBD were enrolled. Their general information, medication adherence, and parental disease-related knowledge were collected by questionnaires. According to the medication adherence score, the children were divided into the adherence group (score of 6 to 8) and the non-adherence group (score of <6), then the demographic and clinical characteristics of the two groups were compared. Subsequently, a multivariate binary Logistic regression analysis was performed to determine the risk factors of medication non-adherence. Results: Of the 112 children, 76 were males and 36 females, with the age of 12.9 (9.5, 14.0) years. There were 50 (44.6%) in the non-adherence group and 62 (55.4%) in the adherence group. Regarding the demographic and clinical characteristics, the results showed that the dosage frequency and the parental disease related knowledge were associated with medication non-adherence (both P<0.05). Multivariate binary Logistic regression analysis showed that compared with 0-6 years old children, the risk of medication non-adherence was significantly increased in children aged 7-12 years (OR=9.30, 95%CI 1.58-54.87, P=0.014) and 13-18 years (OR=8.26, 95%CI 1.49-45.85, P=0.016); and the risk was also significantly increased in children who took medication twice or more per day (OR=12.88, 95%CI 2.77-59.80, P=0.001) compared with children who took medication once per day. Meanwhile, the parental score of the questionnaire on Crohn's disease and ulcerative colitis related knowledge (OR=0.76, 95%CI 0.66-0.89, P=0.001) was also a significant risk factor. Conclusions: Medication non-adherence is common in children with IBD. Children older than 7 years, a dosage frequency of twice or more per day, and parental poor disease-related knowledge are the independent risk factors for medication non-adherence in children with IBD. Clinicians should pay attention to promoting patients' adherence to improve clinical outcomes.
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