title: Factors associated with adherence to treatment in children and adolescents with chronic rheumatic diseases.
abstract: OBJECTIVE
  There are several factors that contribute to poor adherence to treatment in children and adolescents with chronic rheumatic diseases, worsening their quality of life and prognosis. Our aim was to assess the rates of adherence to treatment and to identify the socioeconomic and clinical factors associated.
  
  
  METHODS
  The sample included 99 patients with juvenile idiopathic arthritis, systemic erythematosus lupus, dermatomyositis or juvenile scleroderma. All patients were followed at the outpatient pediatric rheumatology for a minimum period of 6 months. To assess adherence, a questionnaire was administered to the providers, which included three blocks: 1) demographic, clinical and laboratory data; 2) medication adherence; and 3) attending follow-up appointments, examinations and use of orthoses. A value lower than or equal to 80% of the prescribed was considered poor adherence.
  
  
  RESULTS
  A total of 53% of patients showed good overall adherence, observed when the caregiver lived in a stable union marital status (p = 0.006); 20 patients (20.2%) presented poor medication adherence, related to the use of three or more medications daily (p = 0.047). The causes of poor adherence were forgetfulness, refusal, incorrect dose or lack of medication, personal problems, and financial difficulties.
  
  
  CONCLUSIONS
  We observed good overall treatment adherence in patients whose providers lived in stable union and poor adherence to medication in patients who used more than three types of medication daily. There was no association between the adherence rates and sex, age, time since diagnosis and disease activity.
authors.affiliation: Universidade Federal de São Paulo, Escola Paulista de Medicina, São Paulo, SP, Brazil.
authors.forename: Vanessa M
authors.initials: VM
authors.lastname: Bugni
authors.forename: Luciana S
authors.initials: LS
authors.lastname: Ozaki
authors.forename: Karine Y K
authors.initials: KY
authors.lastname: Okamoto
authors.forename: Cássia M P L
authors.initials: CM
authors.lastname: Barbosa
authors.forename: Maria Odete E
authors.initials: MO
authors.lastname: Hilário
authors.forename: Cláudio A
authors.initials: CA
authors.lastname: Len
authors.forename: Maria Teresa
authors.initials: MT
authors.lastname: Terreri
mesh_terms: D000293:Adolescent; D001938:Brazil; D017028:Caregivers; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D006801:Humans; D011446:Prospective Studies; D012216:Rheumatic Diseases / Q000628:therapy*; D012307:Risk Factors; D012959:Socioeconomic Factors; D016903:Drug Monitoring