Early Detection of Poor Adherence to Treatment of Pediatric Rheumatic Diseases: Pediatric Rheumatology Adherence Questionnaire - A Pilot Study

Silva, Vanessa Bugni Miotto e; Okamoto, Karine Yoshiye Kajiyama; Ozaki, Luciana da Silva; Len, Cláudio Arnaldo; Terreri, Maria Teresa

doi:10.1590/1984-0462/;2019;37;2;00015

Cited by 6 publications

(10 citation statements)

References 25 publications

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“…There are factors associated with nonadherence to drug therapy in cSLE and other chronic rheumatic conditions, including forgetfulness, low socioeconomic status, family disruption, polypharmacy, and psychiatric comorbidities [37,177,178]. Poor compliance contributes to negatives outcomes and decreases the health-related quality of life [179][180][181]. Scalzi et al created an online educational program for a cohort of SLE adolescents and young adults.…”

Section: Csle Prognosis Factorsmentioning

confidence: 99%

“…Thus, it is recommended that medication adherence should be checked during the pediatric rheumatologist appointments, especially before any decisions around treatment modifications [2,96]. Understanding and responding to adolescent demands with a personalized treatment plan and multidisciplinary teams, including psychological/psychiatric support, health education strategies, and adherence interventions may help cSLE teens to increase compliance with treatment [37,174,176,181,182].…”

Section: Csle Prognosis Factorsmentioning

confidence: 99%

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An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

et al. 2021

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Childhood-onset systemic lupus erythematosus (cSLE) is a prototype of a multisystemic, inflammatory, heterogeneous autoimmune condition. This disease is characterized by simultaneous or sequential organ and system involvement, with unpredictable flare and high levels of morbidity and mortality. Racial/ethnic background, socioeconomic status, cost of medications, difficulty accessing health care, and poor adherence seem to impact lupus outcomes and treatment response. In this article, the management of cSLE patients is updated. Regarding pathogenesis, a number of potential targets for drugs have been studied. However, most treatments in pediatric patients are off-label drugs with recommendations based on inadequately powered studies, therapeutic consensus guidelines, or case series. Management practices for cSLE patients include evaluations of disease activity and cumulative damage scores, routine non-live vaccinations, physical activity, and addressing mental health issues. Antimalarials and glucocorticoids are still the most common drugs used to treat cSLE, and hydroxychloroquine is recommended for nearly all cSLE patients. Disease-modifying antirheumatic drugs (DMARDs) should be standardized for each patient, based on disease flare and cSLE severity. Mycophenolate mofetil or intravenous cyclophosphamide is suggested as induction therapy for lupus nephritis classes III and IV. Calcineurin inhibitors (cyclosporine, tacrolimus, voclosporin) appear to be another good option for cSLE patients with lupus nephritis. Regarding B-cell-targeting biologic agents, rituximab may be used for refractory lupus nephritis patients in combination with another DMARD, and belimumab was recently approved by the US Food and Drug Administration for cSLE treatment in children aged > 5 years. New therapies targeting CD20, such as atacicept and telitacicept, seem to be promising drugs for SLE patients. Anti-interferon therapies (sifalimumab and anifrolumab) have shown beneficial results in phase II randomized control trials in adult SLE patients, as have some Janus kinase inhibitors, and these could be alternative treatments for pediatric patients with severe interferon-mediated inflammatory disease in the future. In addition, strict control of proteinuria and blood pressure is required in cSLE, especially with angiotensin-converting enzyme inhibitor and angiotensin receptor blocker use.

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Section: Csle Prognosis Factorsmentioning

confidence: 99%

Section: Csle Prognosis Factorsmentioning

confidence: 99%

An Update on the Management of Childhood-Onset Systemic Lupus Erythematosus

et al. 2021

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“…No Brasil, os estados com melhores qualidade de vida e maior poder aquisitivo, como São Paulo e Rio de Janeiro, conseguem atingir taxas dentro da faixa de países desenvolvidos, respectivamente 75,8% e 76% (Silva et al 2019, Pelajo et al 2012. Já a taxa de adesão ao tratamento no Ceará, um estado com qualidade de vida e poder aquisitivo inferior quando comparado as grandes capitais nacionais, como São Paulo e Rio de Janeiro, foi de 46,5% em crianças (Adriano et al, 2017).…”

Section: Discussionunclassified

Índices e fatores relacionados à adesão ao tratamento farmacológico em pacientes com Artrite Idiopática Juvenil

Pinho¹,

Rabelo²,

Rabelo³

et al. 2023

RSD

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A artrite idiopática juvenil (AIJ) é uma forma de artrite crônica que começam antes dos 16 anos idade. Fatores ambientais, socioeconômicos e terapêuticos podem influenciar na adesão ao tratamento, gravidade e percepção da doença. O objetivo foi identificar as taxas de adesão e os fatores que dificultam o tratamento em pacientes com AIJ no Brasil e no mundo. Trata-se de uma revisão da literatura, conduzida no período de 1999 a 2020, a partir da busca de publicações nas seguintes bases de dados: PubMed, LILACS, Scielo e Science direct. Após aplicação dos critérios de inclusão e exclusão, de 189 publicações permaneceram 11. Dos 11 estudos selecionados sobre adesão, 4 foram nos Estados Unidos, 3 no Canadá, 1 na Espanha e 4 no Brasil. Com relação à adesão, os Estados Unidos apresentaram valor máximo de 82%. Já o Brasil apresentou valor máximo de 76%. Os estudos selecionados também revelaram que a principal barreira para a adesão em pacientes com AIJ é o medo das consequências do uso da terapia. No Brasil, outros fatores, tais como: o alto custo, a dificuldade de acesso ao serviço de saúde, ao especialista e ao medicamento, bem como a distância geográfica interferem na adesão. O Brasil apresenta valores de adesão ao tratamento similares àqueles encontrados em países desenvolvidos, entretanto, ainda existem disparidades locais e regionais com relação à adesão. Estas disparidades podem ser explicadas em parte pela dificuldade de acesso tanto aos serviços de saúde quanto ao medicamento e ao abandono do seguimento farmacoterapêutico.

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“…The maximum number that can be obtained is 25 points, but it does not have a specific cut-off value. 13 …”

Section: Methodsmentioning

confidence: 99%

“…The Pediatric Rheumatology Adherence Questionnaire (PRAQ) is a quantitative questionnaire developed in Brazil, which seeks to earlier detect the risk of adherence to treatment in children/adolescents with chronic rheumatic diseases. 13 …”

Section: Introductionmentioning

confidence: 99%