La Tunisie medicale · 2025
Adherence to Disease Modifying Anti Rheumatic Drugs in Tunisian patients with Juvenile Idiopathic Arthritis: An Observational study.
СтатьяНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Fazaa Alia, Selmi Asma, Saad Azza, Miladi Sawssen, Boussaa Hiba, Makhlouf Yasmine, Ben Abdelghani Kaouther, Laatar Ahmed
Аннотация
INTRODUCTION: Non-adherence or poor therapeutic adherence appears to be particularly prevalent in chronic inflammatory rheumatism, notably in Juvenile Idiopathic Arthritis (JIA). It reduces therapeutic efficacy, accelerates disease progression, and poses a significant public health and economic challenge.
AIM: To evaluate adherence to disease-modifying treatments in Tunisian patients with JIA and to identify factors influencing therapeutic adherence.
METHODS: This cross-sectional study included patients with JIA (defined by ILAR criteria) who had been undergoing treatment with conventional synthetic (csDMARDs) and/or biologic (bDMARDs) disease-modifying anti-rheumatic drugs for at least three months. Socio-demographic, clinical, biological, radiological, and therapeutic data were collected. Therapeutic adherence was assessed using two methods: self-reported adherence by patients and their parents, and adherence measured via the Parent Adherence Report Questionnaire (PARQ) and the Child Adherence Report Questionnaire (CARQ).
RESULTS: A total of 30 patients (16 girls, 14 boys) with a mean age of 24.8 ± 11 years [8-47] were included. csDMARDs were prescribed for 76.7% of patients while 26.7% received bDMARDs. Self-reported adherence was 80% among parents and 76.7% among patients. Mean adherence scores were 74.58 ± 36 [0-100] on the PARQ and 74 ± 34 [0-100] on the CARQ. Univariate analysis revealed that adherence measured by the PARQ was positively correlated with erythrocyte sedimentation rate (ESR) (p=0.001; r=0.643) and C-reactive protein (CRP) (p=0.008; r=0.561) and negatively correlated with maternal age (p=0.005; r=-0.572), difficulty in medication administration reported by the parent (p0.0001; r=-0.698), and negative reactions to medication reported by both the patient (p=0.012; r=-0.506) and the parent (p=0.001; r=-0.651). Adherence measured by the CARQ was significantly associated with indigent health insurance status (p=0.019). In multivariate analysis, predictors of non-adherence on the PARQ included advanced maternal age (p=0.004), low ESR (p=0.029), and negative reactions to medications (p0.0001). On the CARQ, difficulty in adhering to the treatment regimen (p=0.042) was the only significant predictor.
CONCLUSION: This study demonstrates good therapeutic adherence among Tunisian patients with JIA. Predictors of non-adherence included advanced maternal age, low disease activity, negative reactions to medications, and difficulties in following treatment regimens. Educational strategies targeting these factors may improve adherence and enhance patient outcomes.
AIM: To evaluate adherence to disease-modifying treatments in Tunisian patients with JIA and to identify factors influencing therapeutic adherence.
METHODS: This cross-sectional study included patients with JIA (defined by ILAR criteria) who had been undergoing treatment with conventional synthetic (csDMARDs) and/or biologic (bDMARDs) disease-modifying anti-rheumatic drugs for at least three months. Socio-demographic, clinical, biological, radiological, and therapeutic data were collected. Therapeutic adherence was assessed using two methods: self-reported adherence by patients and their parents, and adherence measured via the Parent Adherence Report Questionnaire (PARQ) and the Child Adherence Report Questionnaire (CARQ).
RESULTS: A total of 30 patients (16 girls, 14 boys) with a mean age of 24.8 ± 11 years [8-47] were included. csDMARDs were prescribed for 76.7% of patients while 26.7% received bDMARDs. Self-reported adherence was 80% among parents and 76.7% among patients. Mean adherence scores were 74.58 ± 36 [0-100] on the PARQ and 74 ± 34 [0-100] on the CARQ. Univariate analysis revealed that adherence measured by the PARQ was positively correlated with erythrocyte sedimentation rate (ESR) (p=0.001; r=0.643) and C-reactive protein (CRP) (p=0.008; r=0.561) and negatively correlated with maternal age (p=0.005; r=-0.572), difficulty in medication administration reported by the parent (p0.0001; r=-0.698), and negative reactions to medication reported by both the patient (p=0.012; r=-0.506) and the parent (p=0.001; r=-0.651). Adherence measured by the CARQ was significantly associated with indigent health insurance status (p=0.019). In multivariate analysis, predictors of non-adherence on the PARQ included advanced maternal age (p=0.004), low ESR (p=0.029), and negative reactions to medications (p0.0001). On the CARQ, difficulty in adhering to the treatment regimen (p=0.042) was the only significant predictor.
CONCLUSION: This study demonstrates good therapeutic adherence among Tunisian patients with JIA. Predictors of non-adherence included advanced maternal age, low disease activity, negative reactions to medications, and difficulties in following treatment regimens. Educational strategies targeting these factors may improve adherence and enhance patient outcomes.