Most parents start their child on his or her treatment plan with the best of intentions.

Anxious for their child with juvenile arthritis to feel better, parents and child follow physicians’ recommendations precisely.

Medications are taken, therapeutic exercises are done, results are monitored. But sticking with an often complex plan month after month is daunting and adherence can easily slip, even when you know its importance.

If you and your child have missed a physical therapy session or forgotten to take a pill, you are not alone. A study of newly diagnosed kids with juvenile arthritis found 70 percent adherence rates at first but after a year those numbers dropped to about 50 percent. Michael Rapoff, PhD, chief of behavioral pediatrics at the University of Kansas Medical Center who led that study team says, “It’s probably safe to say that a third to a half of kids are not consistent with their treatment plans.”

Reasons for noncompliance are many including the challenge of taking multiple medications sometimes at different times of the day; side effects that may include stomach upset and weight gain; and frustration over the waxing and waning nature of arthritis symptoms.

Another big stumbling block is the way some of the drugs take time to show a positive effect, perhaps six to eight weeks. Patients may give up on the drug before it has a chance to kick in. And once the medication gets into their systems, a few doses can be missed without an immediate effect so parents and kids may think the drug isn’t doing anything. Despite these difficulties, sticking with your treatment plan is key.

“Overall, the outcome for the arthritis is related to compliance with the medication which controls the inflammation,” says Carol Lindsley, MD, chief of pediatric rheumatology at the University of Kansas City Medical Center. “If we control the inflammation, then we prevent complications from arthritis in the majority of children.”

And if a child’s symptoms can be controlled for a significant period of time, they may be able to get off the medication altogether. So how do you and your child keep on track day in and day out?

Understand why

Parents and kids need to understand all the components of the treatment plan. If you don’t know why you’re taking a certain pill or doing a certain exercise, you may be more likely to skip it. And open communication with your physician is critical so you can ask for explanations or feel comfortable enough to tell him when something is not working.