What is it about?

This systematic review examined facilitators and barriers to self-management in juvenile arthritis. The 32 articles included varied in treatment type (e.g., medication, exercise, splinting, etc.) and in how they measured adherence to treatment type (e.g., pharmacy refills, parent report, child report, etc.). This systematic review found that the most common barriers to self-management were communication-related (i.e., between parent and provider and between parent and child). The age of the child and their desire for greater autonomy in decisions about their treatment regimen were other identified barriers. Facilitators of self-management included more parental involvement, use of reminder tools, reports of good provider communication, belief in treatment effectiveness, higher disease severity, and fewer medication side effects. Finally, it was found that self-management was higher for those with medication as their primary treatment compared to those with exercise as their primary treatment.

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Why is it important?

As juvenile arthritis cannot be cured, identifying potential barriers and facilitators for self-management is vital for successful symptom management. This systematic review found that provider communication is essential in improving self-management for this population. Identifying barriers that can result in gaps in caregiver and provider communication can aid providers in demystifying the treatment and the intended outcomes for patients and families. Overall, this study provides insight for healthcare workers into potential starting points for improving self-management in pediatric patients with juvenile arthritis. Special thanks to the Division 54 Adherence and Self-Management SIG trainee member, Johanna Michlig, BA, for her contributions to this Kudos post!

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This page is a summary of: Adherence in young people living with juvenile arthritis: A systematic review., Clinical Practice in Pediatric Psychology, April 2023, American Psychological Association (APA),
DOI: 10.1037/cpp0000483.
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