Pediatr Rheumatol Online J. 2011 Dec 6;9(1):35. doi: 10.1186/1546-0096-9-35.

Self-management skills in adolescents with chronic rheumatic disease: A cross-sectional survey.

Lawson EF, Hersh AO, Applebaum MA, Yelin EH, Okumura MJ, von Scheven E.

Source

Department of Pediatrics, Division of Rheumatology & Immunology, University of California, San Francisco, 533 Parnassus, Rm U-127, Box 0107, San Francisco, CA 94143, USA. lawsone@peds.ucsf.edu.

Abstract

BACKGROUND:

For adolescents with a diagnosis of lifelong chronic illness, mastery of self-management skills is a critical component of the transition to adult care. This study aims to examine self-reported medication adherence and self-care skills among adolescents with chronic rheumatic disease.

METHODS:

Cross-sectional survey of 52 adolescent patients in the Pediatric Rheumatology Clinic at UCSF. Outcome measures were self-reported medication adherence, medication regimen knowledge and independence in health care tasks. Predictors of self-management included age, disease perception, self-care agency, demographics and self-reported health status. Bivariate associations were assessed using the Student's t-test, Wilcoxon rank sum test and Fisher exact test as appropriate. Independence in self-management tasks were compared between subjects age 13-16 and 17-20 using the chi-squared test.

RESULTS:

Subjects were age 13-20 years (mean 15.9); 79% were female. Diagnoses included juvenile idiopathic arthritis (44%), lupus (35%), and other rheumatic conditions (21%). Mean disease duration was 5.3 years (SD 4.0). Fifty four percent reported perfect adherence to medications, 40% reported 1-2 missed doses per week, and 6% reported missing 3 or more doses. The most common reason for missing medications was forgetfulness. Among health care tasks, there was an age-related increase in ability to fill prescriptions, schedule appointments, arrange transportation, ask questions of doctors, manage insurance, and recognize symptoms of illness. Ability to take medications as directed, keep a calendar of appointments, and maintain a personal medical file did not improve with age.