title: Medication adherence in patients with juvenile idiopathic arthritis.
abstract: OBJECTIVE
  The aim of this study was to investigate pharmacological treatment adherence of patients with juvenile idiopathic arthritis, attended in an outpatient pharmacy at a tertiary hospital in northeastern Brazil.
  
  
  METHODS
  The analysis of adherence was performed along with caregivers, through a structured questionnaire based on Morisky, Green and Levine, which enabled the categorization of adherence in "highest", "moderate" or "low" grades, and through evaluating medication dispensing registers, which classified the act of getting medications at the pharmacy as "regular" or "irregular". Drug Related Problems (DRP) were identified through the narrative of caregivers and classified according to the Second Granada Consensus. Then, a pharmaceutical orientation chart with information about the therapeutic regimen was applied, in order to function as a guide for issues that influenced adherence.
  
  
  RESULTS
  A total of 43 patients was included, with a mean age of 11.12 years, and 65.1% (n=28) were female. Applying the questionnaire, it was found "highest" adherence in 46.5% (n=20) patients, "moderate" adherence in 48.8% (n=21), and "low" adherence in 4.7% (n=2). Through an analysis of the medication dispensing registers, a lower level of adherence was observed: only 25.6% (n=11) of the participants received "regularly" the medications. Twenty-six DRP was identified, and 84.6% (n=22) were classified as real. There were no significant associations between socio-demographic variables and adherence, although some caregivers have reported difficulty in accessing the medicines and in understanding the treatment.
  
  
  CONCLUSIONS
  Our findings showed problems in the adherence process related to inattention, forgetfulness and irregularity in getting medicines, reinforcing the need for the development of strategies to facilitate a better understanding of treatment and to ensure adherence.
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil; Hospital Infantil Albert Sabin (HIAS), Fortaleza, CE, Brazil. Electronic address: lianasilveira93@hotmail.com.
authors.forename: Liana Silveira
authors.initials: LS
authors.lastname: Adriano
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Marta Maria
authors.initials: MM
authors.lastname: de França Fonteles
authors.affiliation: Hospital Infantil Albert Sabin (HIAS), Fortaleza, CE, Brazil.
authors.forename: Maria
authors.initials: M
authors.lastname: de Fátima Menezes Azevedo
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Milena Pontes Portela
authors.initials: MP
authors.lastname: Beserra
authors.affiliation: Universidade Federal do Ceará (UFC), Fortaleza, CE, Brazil.
authors.forename: Nirla Rodrigues
authors.initials: NR
authors.lastname: Romero
mesh_terms: D000293:Adolescent; D001171:Arthritis, Juvenile / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D001938:Brazil; D017028:Caregivers / Q000193:education / Q000706:statistics & numerical data*; D002648:Child; D017723:Drug Utilization Review; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006302:Health Services Research; D006801:Humans; D008297:Male; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010594:Pharmacies; D011795:Surveys and Questionnaires; D016903:Drug Monitoring
keywords: Adesão ao tratamento farmacológico; Artrite juvenil idiopática; Atenção farmacêutica; Juvenile idiopathic arthritis; Medication adherence; Pharmaceutical care