Background. Measurement of the degree of adherence is a key element for the evaluation of treatment efficacy and safety; thus,\nadherence plays an important role in clinical research and practice. The aim of this study was to investigate medication adherence in\nchildren with inflammatory bowel disease (IBD) utilizing a multimethod assessment approach. A further aim was to examine factors\nthat can influence adherence within this population. Methods. Medication adherence in 47 children (age range 3 to 17 years) with IBD\nin three centers in Northern Ireland and Jordan was assessed via subjective (parent and child versions of the Medication Adherence\nReport Scale (MARS) specific questionnaire) and objective methods, that is, high-performance liquid chromatography (HPLC)\ndetermination of the 6-mercaptopurine (6-MP) and azathioprine (AZA) metabolites in packed red blood cell samples taken during a\nclinic visit. Beliefs about prescribed medicines were also assessed in parents/guardians using the Beliefs about Medicines Questionnaire\n(BMQ). Results. An overall nonadherence to AZA/6-MP therapy in children with IBD was found to be 36.17% (17 out of 47 patients\nwere classified as nonadherent using at least one of the assessment methods). A total of 41 patients (91.1%) were classified as adherent to\nAZA or 6-MP using the blood sampling, while adherence rates using the MARS questionnaire completed by children and parents/\nguardians were 60.6% and 72.7%, respectively. The latter provides a more longitudinal measure of adherence. Child self-reported\nnonadherence rates were significantly higher than parent/guardian reported rates.....................
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