Kidney Week

Abstract: SA-PO658

Assessment of Medication Adherence among Children with Glomerular Diseases

Session Information

• Pediatric Nephrology - 2
  October 26, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Pediatric Nephrology

• 1900 Pediatric Nephrology

Authors

• Krissberg, Jill, Northwestern University Feinberg School of Medicine, Chicago, Illinois, United States

Jill Krissberg, MD

• Larkina, Maria, University of Michigan, Ann Arbor, Michigan, United States

Maria Larkina, MS

• Helmuth, Margaret, University of Michigan, Ann Arbor, Michigan, United States

Margaret Helmuth, MA

• Smith, Abigail R., Northwestern University, Evanston, Illinois, United States

Abigail R. Smith, PhD

• Wang, Chia- Shi, Emory University, Atlanta, Georgia, United States

Chia- Shi Wang, MD, MS

• Vasylyeva, Tetyana L., Texas Tech University Health Sciences Center, Lubbock, Texas, United States

Tetyana L. Vasylyeva, MD, PhD

• Lafayette, Richard A., Stanford University School of Medicine, Stanford, California, United States

Richard A. Lafayette, MD

• Tuttle, Katherine R., University of Washington School of Medicine, Seattle, Washington, United States

Katherine R. Tuttle, MD, FASN

Group or Team Name

• Cure Glomerulonephropathy.

Background

Children with glomerular disease (GD) are subjected to complicated medication regimens where a high frequency of nonadherence has been described. While adult studies in kidney disease have identified differences in adherence for patients of racial or ethnic minorities, little is known in children with GD, and what may be driving any observed differences. This study aims to assess patient, treatment, and disease characteristics associated with medication nonadherence practices.

Methods

CureGN is a prospective cohort study of patients with GD diagnosed by biopsy within 5 years prior to enrollment. Adherence is assessed at enrollment and longitudinally by child (≥8 years) or parent (<8 years) completed questionnaires (adapted Medication Adherence Scale or Morisky MGL Medication Adherence Scale). We used multivariable mixed effects logistic regression models to explore associations between race and ethnicity and odds of nonadherence, sequentially adjusting for socioeconomic status, disease characteristics, and medications.

Results

In 692 children with GD (63% Non-Hispanic White, 21% Black, 6% Asian, 10% Hispanic White; 42% female; median [IQR] age of 11 [6, 14] years; 46% privately insured [US] at enrollment) 534 (77%) reported medication nonadherence at least once (median follow-up of 14 [4, 36] months with 4 [2, 6] completed surveys). Odds of nonadherence was higher for Black children (OR 1.58, 95% CI 1.06-2.38) and Hispanic White children (OR 1.64, 95% CI 1.00-2.68) vs Non-Hispanic White children, and for children with obesity (OR 1.99, 95% CI 1.43-2.79). Older age, international public insurance, hypertension, and presence of edema were associated with lower odds of non-adherence.

Conclusion

Medication non-adherence is common in children with GD and associated with Black race, Hispanic ethnicity and obesity, while lower odds of nonadherence were observed with older age, insurance type, and markers. These characteristics may help inform strategies to support medication adherence.

Funding

• NIDDK Support