Evaluation of adherence to medication treatment in pediatric patients with cystic fibrosis; a cross-sectional study

Background: Cystic fibrosis is a complex, multi-system impairment with poly pharmacy which affects both children and their parents. Adherence to treatment is essential to optimize CF disease management. Aims and Objectives: The aim of the present study was to evaluate the medication adherence and indeed identify the factors affecting adherence in this population. Methods: An observational prospective study was conducted to recruited CF outpatient at the CF clinic of Children’s Medical Center in Iran. Children with CF and their parents were consecutively recruited. Baseline data, medical history, clinical outcome data, were collected via interview and review of medical notes. The Morisky Medication Adherence scale (MMAS) was used to measure adherence. Results: Three hundred patients with CF (age 1-25 years, mean 7.6 years, 58.7% males) and parent pairs were recruited. The mean score of MMAS in pulmonary, antibiotics, gastrointestinal and supplement medications was 5.1, 4.6, 4.1 and 3.3 respectively. According to the categorization of Morisky Scale, 58% of patients who received inhaler medications and 65% of patients who received antibiotics had a low adherence (lower than 6 scores). High adherence was associated with child age, parental higher educational degree and their beliefs, duration of illness and frequency of healthcare visit ((P=0.001). Conclusion: The results indicated that the non-adherence was very common in patients with CF. Our results suggest the need for educational interventions and planned patient monitoring program in patients with CF to optimize management and health outcomes.