Adherence to drug treatment in children and adolescents with cystic fibrosis

Abstract

Introduction: To assess adherence to pharmacotherapy in pediatric patients with cystic fibrosis, associating it with socioeconomic, clinical, and nutritional variables. Methods: Cross-sectional study, including patients aged 0 to 18 with a diagnosis of cystic fibrosis. To assess adherence, the self-report questionnaire Brief Medication Questionnaire (BMQ) and medication withdrawals from the pharmacy over 12 months were used. The average medication possession rate (CMPR) was calculated for each patient and classified into two groups: high adherence (≥0.8) and moderate/low adherence (<0.8). The Shwachman-Kulczycki (SK) and Bhalla scores, spirometry, and nutritional diagnosis were obtained. Results: Of the 85 patients, 37.6% adhered to treatment according to the BMQ, and 64% according to the CMPR. The general analysis showed an association between CMPR and clinical score (p=0.013), Bhalla score (p=0.02), and better nutritional diagnosis (p=0.045). Dividing the groups by age, in the 0-5 age group there was an association between the family’s socioeconomic factor, the CMPR (p=0.017), and the BMQ (0.008). In the 6-18 age group, there was an association between the CMPR and the body mass index (BMI) Z-score (p=0.025) and SK (p=0.017). There was also an association between adherence to the BMQ and the belief barrier (p=0.022). There was also an association between the CMPR and the body mass index Z-score (p=0.017), and SK (p=0.025), and an association between adherence to the BMQ and the belief barrier (p=0.022). Conclusion: Adherence to drug treatment by self-reporting was lower than adherence by collecting the drugs from the pharmacy. The clinical score of SK, Bhalla, and the nutritional diagnosis were directly correlated with the CMPR. There was an influence of the socioeconomic factor in younger patients (<6 years), and for older patients (≥6 years) there was an influence of their belief barriers.