Association between perceived treatment adherence and health-related quality of life in children with juvenile idiopathic arthritis: perspectives of both parents and children

Karine Toupin April¹, Debbie Ehrmann Feldman², Maria Victoria Zunzunegui¹, Ciarán M Duffy³

¹Département de médecine sociale et préventive ²École de Réadaptation, Université de Montréal, Montreal, Quebec, Canada; ³Division of Rheumatology, Department of Pediatrics, Montreal Children’s Hospital, Montreal, Quebec, Canada

Objective: The aim of the study was to examine the relationship between perceived treatment adherence and health-related quality of life (HRQOL) in children with arthritis, from both parent and child perspectives.

Methods: Patients and their parents, who attended the juvenile idiopathic arthritis (JIA) clinic at the Montreal Children's Hospital, completed the Juvenile Arthritis Quality of Life Questionnaire (JAQQ), and either the Child Adherence Report Questionnaire (CARQ) or the Parent Adherence Report Questionnaire (PARQ). Linear regression models examined the associations between perceived treatment adherence and HRQOL while adjusting for age, severity, duration of the disease, and complexity of the medical regimen.

Results: Perceived adherence to medications was associated with a better HRQOL total score from the children’s perspective (β = −0.02, 95% confidence interval [CI] = −0.03, −0.004), particularly with respect to gross motor (β = −0.03, 95% CI = −0.05, −0.01) and psychosocial functions (β = −0.03, 95% CI = −0.04, −0.01). According to parents, perceived adherence to exercises was associated with fewer symptoms (β = −0.01, 95% CI = −0.03, 0.000) and better psychosocial functioning (β = −0.01, 95% CI = −0.03, −0.002).

Conclusion: Perceived adherence to medications is associated with an improved HRQOL according to children. According to parents, adherence to exercises may be associated with an improved HRQOL.

Keywords: treatment adherence, juvenile idiopathic arthritis, health-related quality of life