title: Electronically monitored adherence to medications by newly diagnosed patients with juvenile rheumatoid arthritis.
abstract: OBJECTIVE
  To describe patterns of adherence to nonsteroidal antiinflammatory drugs (NSAIDs) in newly diagnosed patients with juvenile rheumatoid arthritis (JRA), and to examine demographic and disease-related variables as potential predictors of adherence.
  
  
  METHODS
  Adherence to NSAIDs was monitored in 48 children with JRA (mean age 8.6 years) over 28 consecutive days using an electronic monitoring device. Measures of disease activity (active joint counts, morning stiffness) and demographics (age, sex, ethnicity, socioeconomic status) were also obtained.
  
  
  RESULTS
  Using an 80% adherence cut point, 25 (52%) patients were classified as adherent and 23 (48%) as nonadherent. There was considerable variability across patients, with full adherence (taking all doses on time) ranging from 0 to 100% of the monitored days. Logistic regression showed that active joint count and socioeconomic status were the only significant predictors. Both were positively related to adherence. The model correctly classified 70.5% of patients as either adherent or nonadherent (Cox and Snell R(2) = 0.295, P = 0.0005).
  
  
  CONCLUSIONS
  Children newly diagnosed with JRA are more likely to adhere to an NSAID regimen if they have a greater number of active joints or their families have higher socioeconomic status. The former finding suggests that children's adherence is symptom-driven, while the latter suggests that families of lower socioeconomic status deserve special attention to address adherence issues.
authors.affiliation: University of Kansas Medical Center, Kansas City, KS 66160-7330, USA. mrapoff@kumc.edu
authors.forename: Michael A
authors.initials: MA
authors.lastname: Rapoff
authors.forename: John M
authors.initials: JM
authors.lastname: Belmont
authors.forename: Carol B
authors.initials: CB
authors.lastname: Lindsley
authors.forename: Nancy Y
authors.initials: NY
authors.lastname: Olson
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D016903:Drug Monitoring / Q000379:methods*; D004581:Electronics; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D010349:Patient Compliance; D012720:Severity of Illness Index; D012923:Social Class
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents