No abstract

\s=b\ We compared adolescents' compliance with medical regimens with that of younger children and identified characteristics of noncompliant adolescents. Compliance among 82 patients with juvenile rheumatoid arthritis (JRA) was monitored using serum salicylate levels. Fifty-five percent of adolescents and 55% of children were found to have good compliance. Among adolescent patients with JRA, however, the following factors were associated with salicylate therapy noncompliance: longer duration of disease (more than six years); earlier age at onset (under 9 years); later time of referral to a subspecialist; shorter duration of subspecialty cl i ni c care; and fewer clinic visits.Knowledge of these variables will facilitate development of intervention strategies tailored to meet the age-specific needs of this population with chronic illness. (Am J Dis Child 1981:135:434-436)The stereotype of adolescent noncompliance with prescribed medi¬ cal regimens is based on limited data. To date, only two studies have under¬ taken to compare adolescents' com¬ pliance with that of younger children.In the first, Korsch et al found 13 of 14 noncompliant patients to be adoles¬ cents,' whereas Smith et al found 59% of adolescents and only 18% of chil¬ dren with neoplasms to be noncom¬ pliant with the prescribed medical regimen.2 In both studies, the medica¬ tion was prednisone, and it is plausible to speculate that its adverse effect on the adolescents' appearance contrib¬ uted to the observed noncompliance. Two other studies of compliance among chronically ill adolescents ex¬ plored its relationship with having the same physician. Meyers et al found no relationship between consistency of physicians and compliance among ad¬ olescents with cystic fibrosis.3 Heinzelmann, however, reported a nega¬ tive association between having the same physician and compliance of col¬ lege students who required penicillin prophylaxis for rheumatic fever.4 He did find that compliance was en¬ hanced when the physician was a spe¬ cialist rather than a generalist. Other than these studies, little has been written about the determinants of medication compliance among adoles¬ cents with chronic illness.0 Compliance with medication for chronic illness has been extensively studied in adults.Factors associated with their noncom¬ pliance include the duration of the illness, complexity of the regimen, lack of symptoms, and long intervals between clinic visits.6 Increasing pa¬ tient supervision,7 simplification of the therapeutic regimen," initiation of a behavioral modification program," and vision of social support'" have been shown to improve compliance among adults with chronic illness in a variety of studies.The present study was undertaken to (1) compare compliance with sodi¬ um salicylate medication of adoles¬ cents with juvenile rheumatoid arthritis (JRA) with that of younger children, and (2) to identify character¬ istics that may distinguish adolescent compilers from noncompliers. The objective of this approach is to under¬ stand better the factors that...

No abstract

No abstract

No abstract