Abstract

Objective: Poor adherence to medications is an important problem, especially in patients with chronic diseases such as familial Mediterranean fever (FMF). In this study, we aimed to evaluate medication adherence in pediatric FMF patients and investigate the relationship between disease perception and treatment compliance.

Method: Pediatric patients (<18 years old) with a diagnosis of FMF and at least six months of follow-up period participated in the study. Patient perceptions of illness and medication adherence were measured via a brief illness perception questionnaire (brief IPQ) and the Medication Adherence Scale in FMF Patients (MASIF), respectively.

Results: A total of 50 patients (46% girls, n: 23) with a median age of 9.9 (IQR 5.9-15.8) years were included. The median age at diagnosis was 5.4 (IQR 3.2-10.1) years. Twenty-eight patients (56%) had good medication adherence (the MASIF score>60), while 44% of the patients were non-adherent to the treatment. Patients aged under 12 years of age were more adherent to colchicine treatment than those over 12 years of age (68.2% vs. 25.0%, p= 0.002). The comparison of the illness perception and medication adherence revealed higher brief IPQ total scores in patients who adhered to the treatment (median 48.5 vs 52.5, p=0.037). We found significant differences in timeline scores between patients who were adherent and those who were non-adherent to the treatment (p=0.01).

Conclusion: Non-adherence to medication is an important and widespread problem, particularly among adolescent patients. Perceptions of the illness and beliefs about the duration of the disease may affect adherence to treatment. Medication adherence should be routinely assessed at follow-up visits and educational interventions might improve adherence to the treatment.

Keywords: Familial Mediterranean fever, medication adherence, illness perception

Copyright and license

How to cite

1.
Kaya Akca Ü, Barış S, Öztürk H. The impact of illness perception on medication adherence in pediatric patients with familial Mediterranean fever. Trends in Pediatrics. 2023;4(3):147-154. https://doi.org/10.59213/TP.2023.62533

References

  1. Ozen S, Bilginer Y. A clinical guide to autoinflammatory diseases: familial Mediterranean fever and next-of-kin. Nat Rev Rheumatol. 2014;10:135-47. https://doi.org/10.1038/nrrheum.2013.174
  2. Sönmez HE, Batu ED, Özen S. Familial Mediterranean fever: current perspectives. J Inflamm Res. 2016;9:13-20. https://doi.org/10.2147/JIR.S91352
  3. Chae JJ, Wood G, Masters SL, et al. The B30.2 domain of pyrin, the familial Mediterranean fever protein, interacts directly with caspase-1 to modulate IL-1β production. Proc Natl Acad Sci U S A. 2006;103:9982-7. https://doi.org/10.1073/pnas.0602081103
  4. Sag E, Bilginer Y, Ozen S. Autoinflammatory diseases with periodic fevers. Curr Rheumatol Rep. 2017;19:41. https://doi.org/10.1007/s11926-017-0670-8
  5. Özen S, Sag E, Ben-Chetrit E, et al. Defining colchicine resistance/intolerance in patients with familial Mediterranean fever: a modified-Delphi consensus approach. Rheumatology (Oxford). 2021;60:3799-808. https://doi.org/10.1093/rheumatology/keaa863
  6. Melikoglu MA, Senel K. Non-response to colchicine in familial Mediterranean fever should be identified accurately. Int J Rheum Dis. 2017;20:2118-21. https://doi.org/10.1111/1756-185X.12374
  7. Yesilkaya S, Acikel C, Fidanci BE, et al. Development of a medication adherence scale for familial Mediterranean fever (MASIF) in a cohort of Turkish children. Clin Exp Rheumatol. 2015;33:156-62.
  8. Sönmez HE, Ayaz NA. Ailevi akdeniz ateşi tanısı ile takipli hastalarda ilaç uyumunun hastalık seyrine etkisi. Acta Medica Nicomedia. 2022;5:8-11.
  9. Broadbent E, Petrie KJ, Main J, Weinman J. The brief illness perception questionnaire. J Psychosom Res. 2006;60:631-7. https://doi.org/10.1016/j.jpsychores.2005.10.020
  10. Yalçınkaya F, Özen S, Özçakar ZB, et al. A new set of criteria for the diagnosis of familial Mediterranean fever in childhood. Rheumatology (Oxford). 2009;48:395-8. https://doi.org/10.1093/rheumatology/ken509
  11. Chew BH, Vos RC, Heijmans M, Shariff-Ghazali S, Fernandez A, Rutten GEHM. Validity and reliability of a Malay version of the brief illness perception questionnaire for patients with type 2 diabetes mellitus. BMC Med Res Methodol. 2017;17:118. https://doi.org/10.1186/s12874-017-0394-5
  12. Bilondi SS, Noghabi AD, Aalami H. The relationship between illness perception and medication adherence in patients with diabetes mellitus type II: illness perception and medication adherence. J Prev Med Hyg. 2022;62:E966-71. https://doi.org/10.15167/2421-4248/jpmh2021.62.4.2277
  13. Chen SL, Tsai JC, Lee WL. The impact of illness perception on adherence to therapeutic regimens of patients with hypertension in Taiwan. J Clin Nurs. 2009;18:2234-44. https://doi.org/10.1111/j.1365-2702.2008.02706.x
  14. Tolu S, Rezvani A, Karacan İ, et al. Self-reported medication adherence in patients with ankylosing spondylitis: the role of illness perception and medication beliefs. Arch Rheumatol. 2020;35:495-505. https://doi.org/10.46497/ArchRheumatol.2020.7732
  15. Hughes L, Done J, Young A. Patients that report high adherence to DMARDs show higher perceptions of serious consequences and negative emotional response to rheumatoid arthritis than patients with low self reported adherence. Annals of the Rheumatic Diseases. 2011;70:760.
  16. Ozen S, Demirkaya E, Erer B, et al. EULAR recommendations for the management of familial Mediterranean fever. Ann Rheum Dis. 2016;75:644-51. https://doi.org/10.1136/annrheumdis-2015-208690
  17. Yildirim DG, Bakkaloglu SA, Acar ASS, Celik B, Buyan N. Evaluation of quality of life and its associations with clinical parameters in pediatric patients with familial Mediterranean fever. North Clin Istanb. 2021;8:255-60. https://doi.org/10.14744/nci.2020.90093
  18. Tekgöz E, Çolak S, Çınar Fİ, Yılmaz S, Çınar M. Non-adherence to colchicine treatment is a common misevaluation in familial Mediterranean fever. Turk J Med Sci. 2021;51:2357-63. https://doi.org/10.3906/sag-2102-328
  19. Sönmez HE, Esmeray P, Batu ED, et al. Is age associated with disease severity and compliance to treatment in children with familial Mediterranean fever? Rheumatol Int. 2019;39:83-7. https://doi.org/10.1007/s00296-018-4123-0
  20. Taddeo D, Egedy M, Frappier JY. Adherence to treatment in adolescents. Paediatr Child Health. 2008;13:19-24. https://doi.org/10.1093/pch/13.1.19
  21. Staples B, Bravender T. Drug compliance in adolescents: assessing and managing modifiable risk factors. Paediatr Drugs. 2002;4:503-13. https://doi.org/10.2165/00128072-200204080-00003