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Treatment Adherence in Adolescence

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Handbook of Adolescent Health Psychology

Abstract

Treatment nonadherence involves the failure to follow medical recommendations and to maintain behavioral commitment to disease management. Among adolescents, nonadherence can significantly limit treatment outcomes and potentially endanger health status. Successful adherence to (or compliance with) both acute and chronic care regimens tends to be lower among adolescents than among both adults and younger children. This chapter examines the challenges of treatment adherence in the care of adolescents, as well as emerging research and clinical efforts to enhance adolescent commitment to their self-care. Provider–patient communication, patient motivation, and both barriers to and supports of adolescent behavioral self-management are considered. Family issues and the role of parents and peers in the transition to adolescent control and responsibility for illness management are also examined. Validated interventions to improve adolescent adherence are reviewed, and recommendations for future research are offered.

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References

  • Bearman, K. J., & La Greca, A. M. (2002). Assessing friend support of adolescents’ diabetes care: The diabetes social questionnaire—Friends version. Journal of Pediatric Psychology, 27(5), 417–428.

    Article  PubMed  Google Scholar 

  • Berrien, V. M., Salazar, J. C., Reynolds, E., & Mckay, K. (2004). Adherence to antiretroviral therapy in HIV-infected pediatric patients improves with home-based intensive nursing intervention. AIDS Patient Care and STDs, 18(6), 355–363.

    Article  PubMed  Google Scholar 

  • Blotcky, A. D., Cohen, D. G., Conaster, C., & Klopovich, P. (1985). Psychosocial characteristics of adolescents who refuse cancer treatment. Journal of Consulting and Clinical Psychology, 53, 729–731.

    Article  PubMed  Google Scholar 

  • Brownbridge, B., & Fielding, D. (1989). An investigation of psychological factors influencing adherence to medial regime in children and adolescents undergoing haemodialysis and CAPD. International Journal of Adolescent Medicine and Health, 4, 7–18.

    Google Scholar 

  • Chappuy, H., Treluyer, J. M., Faesch, S., Giraud, C., & Cheron, G. (2009). Length of the treatment and number of doses per day as major determinants of child adherence to acute treatment. Acta Paediatrica, 99(3), 433–437.

    Article  PubMed  Google Scholar 

  • Chmelik, F., & Doughty, A. (1994). Objective measurements of compliance in asthma treatment. Annals of Allergy, 73, 527–532.

    PubMed  Google Scholar 

  • Christian, B. J., & D’Auria, J. P. (1997). The child’s eye: Memories of growing up with cystic fibrosis. Journal of Pediatric Nursing, 12(1), 3–12.

    Article  PubMed  Google Scholar 

  • Coutts, J. A., Gibson, N. A., & Paton, J. Y. (1992). Measuring compliance with inhaled medication in asthma. Archives of Disease in Childhood, 67(3), 332–333.

    Article  PubMed  Google Scholar 

  • Cox, D. J., & Gonder-Frederick, L. (1992). Major developments in behavioral diabetes research. Journal of Consulting and Clinical Psychology, 60, 628–638.

    Article  PubMed  Google Scholar 

  • Dawson, A., & Newell, R. (1994). The extent of parental compliance with timing of administration of their children’s antibiotics. Journal of Advanced Nursing, 20, 483–490.

    Article  PubMed  Google Scholar 

  • Dean, A. J., Walters, J., & Hall, A. (2010). A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness. Archives of Disease in Childhood, 95, 717–723.

    Article  PubMed  Google Scholar 

  • DeLambo, K. E., Ievers-Landis, C. E., Drotar, D., & Quittner, A. L. (2008). Evidence-based assessment of Adherence to Medical Treatments in Pediatric Psychology. Journal of Pediatric Psychology, 33(9), 916–936.

    Article  Google Scholar 

  • DiGirolmo, A. M., Quittner, A. L., Ackerman, V., & Stevens, J. (1997). Identification and assessment of ongoing stressors in adolescents with a chronic illness: An application of the behavior analytic model. Journal of Clinical Child Psychology, 26, 53–66.

    Article  Google Scholar 

  • DiMatteo, M. R. (2004a). Variations in patients’ adherence to medical recommendations: A quantitative review of 50 years of research. Medical Care, 42(3), 200–209.

    Article  PubMed  Google Scholar 

  • DiMatteo, M. R. (2004b). Social support and patient adherence to medical treatment: a meta-analysis. Health Psychology, 23(2), 207–218.

    Article  PubMed  Google Scholar 

  • DiMatteo, M. R., Giordani, P. J., Lepper, H. S., & Croghan, T. W. (2002). Patient adherence and medical treatment outcomes: A meta-analysis. Medical Care, 40(9), 794–811.

    Article  PubMed  Google Scholar 

  • DiMatteo, M. R., Haskard-Zolnierek, K. B., & Martin, L. R. (2012). Improving patient adherence: A three-factor model to guide practice. Health Psychology Review, 6(1), 74–91.

    Article  Google Scholar 

  • DiMatteo, M. R., Hays, R. D., & Sherbourne, C. D. (1992). Adherence to cancer regimens: Implications for treating the older patient. Oncology, 6, 50–57.

    PubMed  Google Scholar 

  • DiMatteo, M. R., Lepper, H. S., & Croghan, T. W. (2000). Depression is a risk factor for noncompliance with medical treatment: Meta-analysis of the effects of anxiety and depression on patient adherence. Archives of Internal Medicine, 160(14), 2101–2107.

    Article  PubMed  Google Scholar 

  • DiMatteo, M. R., Sherbourne, C. D., Hays, R. D., Ordway, L., Kravitz, R. L., McGlynn, E. S., et al. (1993). Physicians’ characteristics influence patients’ adherence to medical treatment: Results from the Medical Outcomes Study. Health Psychology, 12(2), 93–102.

    Article  PubMed  Google Scholar 

  • Drotar, D. (2009). Physician behavior in the care of pediatric chronic illness: Association with health outcomes and treatment adherence. Journal of Developmental and Behavioral Pediatrics, 30(3), 254.

    Article  Google Scholar 

  • Farber, H. J., & Oliveria, L. (2004). Trial of an asthma education program in an inner-city pediatric emergency department. Pediatric Asthma, Allergy & Immunology, 17(2), 107–115.

    Article  Google Scholar 

  • Friedman, I. M., Litt, I. F., King, D. R., Henson, R., Holtzman, D., Halverson, D., et al. (1986). Compliance with anticonvulsant therapy by epileptic youth. Journal of Adolescent Health Care, 7, 12–17.

    Article  PubMed  Google Scholar 

  • Golin, C. E., DiMatteo, M. R., & Gelberg, L. (1996). The role of patient participation in the doctor visit. Implications for adherence to diabetes care. Diabetes Care, 19(10), 1153–1164.

    Article  PubMed  Google Scholar 

  • Hampson, S. E., Glasgow, R. E., & Toobert, D. J. (1990). Personal models of diabetes and their relations to self-care activities. Health Psychology, 9, 516–528.

    Article  Google Scholar 

  • Haskard-Zolnierek, K. B., & DiMatteo, M. R. (2009). Physician communication and patient adherence to treatment: A meta-analysis. Medical Care, 47(8), 826–834.

    Article  Google Scholar 

  • Hays, R. D., & DiMatteo, M. R. (1987). Key issues and suggestions for patient compliance assessment: Sources of information focus of measures, and nature of response options. The Journal of Compliance in Health Care, 2, 37–53.

    Google Scholar 

  • Hovell, M. F., Sipan, C. L., Blumberg, E. J., Hofstetter, C. R., Slymen, D., Friedman, L., et al. (2003). Increasing Latino adolescents’ adherence to treatment for latent tuberculosis infection: A controlled trial. American Journal of Public Health, 93(11), 1871–1877.

    Article  PubMed  Google Scholar 

  • Hughes, D. M., McLeod, M., Garner, B., & Goldbloom, R. B. (1991). Controlled trial of a home and ambulatory program for asthmatic children. Pediatrics, 87(1), 54–61.

    PubMed  Google Scholar 

  • Ievers, C. E., Brown, R. T., Drotar, D., Caplan, D., Pishevar, B. S., & Lambert, R. G. (1999). Knowledge of physician prescriptions and adherence to treatment among children with cystic fibrosis and their mothers. Journal of Developmental and Behavioral Pediatrics, 20(5), 335–343.

    Article  PubMed  Google Scholar 

  • Ingerski, L. M., Baldassano, R. N., Denson, L. A., & Hommel, K. A. (2010). Barriers to oral medication adherence for adolescents with inflammatory bowel disease. Journal of Pediatric Psychology, 35(6), 683–691.

    Article  PubMed  Google Scholar 

  • Jahng, K. H., Martin, L. R., Golin, C. E., & DiMatteo, M. R. (2005). Preferences for medical collaboration: Patient-physician congruence and patient outcomes. Patient Education and Counseling, 57, 308–314.

    Article  PubMed  Google Scholar 

  • Janisse, H. C., Naar-King, S., & Ellis, D. (2010). Brief report: Parent’s health literacy among high-risk adolescents with insulin dependent diabetes. Journal of Pediatric Psychology, 35(4), 436–440.

    Article  PubMed  Google Scholar 

  • Jay, M. S., DuRant, R. H., Shoffitt, T., Linder, C. W., & Litt, I. F. (1984). Effect of peer counselors in adolescent compliance in use of oral contraceptives. Pediatrics, 73(2), 126–131.

    PubMed  Google Scholar 

  • Kovacs, M., Goldston, D., Obrosky, D. S., & Iyengar, S. (1992). Prevalence and predictors of pervasive noncompliance with medical treatment among youths with insulin-dependent diabetes mellitus. Journal of the American Academy of Child and Adolescent Psychiatry, 31, 1112–1119.

    Article  PubMed  Google Scholar 

  • Kravitz, R. L., Hays, R. D., Sherbourne, C. D., DiMatteo, M. R., Rogers, W. H., Ordway, L., et al. (1993). Recall of recommendations and adherence to advice among patients with chronic medical conditions. Archives of Internal Medicine, 153(16), 1869–1878.

    Article  PubMed  Google Scholar 

  • La Greca, A. M., Bearman, K. J., & Moore, H. (2002). Peer relations of youth with pediatric conditions and health risks: Promoting social support and healthy lifestyles. Journal of Developmental and Behavioral Pediatrics, 23(4), 271–280.

    Article  PubMed  Google Scholar 

  • La Greca, A. M., & Hanna, N. (1983). Diabetes-related health beliefs in children and their mothers: Implications for treatment. Diabetes, 32(Suppl. 1), 66.

    Google Scholar 

  • Lewandowski, A., & Drotar, D. (2007). The relationship between parent-reported social support and adherence to medical treatment in families of adolescents with type 1 diabetes. Journal of Pediatric Psychology, 32, 427–436.

    Article  PubMed  Google Scholar 

  • Lewis, C. C., Pantell, R. H., & Sharp, L. (1991). Increasing patient knowledge, satisfaction, and involvement: Randomized trial of communication intervention. Pediatrics, 88(2), 351–358.

    PubMed  Google Scholar 

  • Manning, W., & Wells, K. B. (1992). The effect of psychological distress and psychological well-being on use of medical services. Medical Care, 30, 541–553.

    Article  PubMed  Google Scholar 

  • Martin, L. R., Haskard-Zolnierek, K. B., & DiMatteo, M. R. (2010). Health behavior change and treatment adherence: Evidence-based guidelines for improving healthcare. New York: Oxford University Press.

    Google Scholar 

  • Miller, V. A., & Drotar, D. (2003). Discrepancies between mother and adolescent perceptions of diabetes-related decision-making autonomy and their relationship to diabetes-related conflict and adherence to treatment. Journal of Pediatric Psychology, 28(4), 265–274.

    Article  PubMed  Google Scholar 

  • Miller, V. A., & Drotar, D. (2007). Decision-making competence and adherence to treatment in adolescents with diabetes. Journal of Pediatric Psychology, 32(2), 178–188.

    Article  PubMed  Google Scholar 

  • Modi, A. C., Marciel, K. K., Slater, S. K., Drotar, D., & Quittner, A. L. (2008). The influence of parental supervision on medical adherence in adolescents with cystic fibrosis: Developmental shifts from early to late adolescence. Children’s Health Care, 37, 78–92.

    Article  Google Scholar 

  • Murphy, D. A., Lam, P., Naar-King, S., Harris, D. R., Parsons, J. T., & Muenz, L. R. (2010). Health literacy and antiretroviral adherence among HIV-infected adolescents. Patient Education and Counseling, 79, 25–29.

    Article  PubMed  Google Scholar 

  • New England Healthcare Institute. (2010, December 22). Thinking outside the pillbox: A system wide approach to improving patient medication adherence for chronic disease. Retrieved from http://www.nehi.net/publications/44/thinking_outside_the_pillbox_a_systemwide_approach_to_improving_patient_medication_adherence_for_chronic_disease.

    Google Scholar 

  • Nock, M. K., & Kazdin, A. E. (2005). Randomized controlled trial of a brief intervention for increasing participation in parent management training. Journal of Consulting and Clinical Psychology, 73(5), 872–879.

    Article  PubMed  Google Scholar 

  • Orban, L. A., Stein, R., Koenig, L. J., Conner, L. C., Rexhouse, E. L., Lewis, J. V., et al. (2010). Coping strategies of adolescents living with HIV: Disease-specific stressors and responses. AIDS Care, 22(4), 420–430.

    Article  PubMed  Google Scholar 

  • Phelan, P. D. (1984). Compliance with medication in children. Journal of Paediatrics and Child Health, 20(5), 1440–1754.

    Google Scholar 

  • Prochaska, J. O., DiClemente, C. C., & Norcross, J. C. (1992). In search of how people change. Applications to addictive behaviors. American Psychologist, 47, 1102–1114.

    Article  PubMed  Google Scholar 

  • Rapoff, M. A. (1999). Adherence to pediatric medical regimens. Dordrecht, Netherlands: Kluwer Academic Publishers.

    Google Scholar 

  • Riekert, K. A., & Drotar, D. (1999). Who participates in research on adherence to treatment in insulin-dependent diabetes mellitus? Implications and recommendations for research. Journal of Pediatric Psychology, 24(3), 253–258.

    Article  PubMed  Google Scholar 

  • Rohan, J., Drotar, D., McNally, K., Schluchter, M., Riekert, K., Vavrek, P., et al. (2010). Adherence to pediatric asthma treatment in economically disadvantaged African-American children and adolescents: An application of growth curve analysis. Journal of Pediatric Psychology, 35(4), 394–404.

    Article  PubMed  Google Scholar 

  • Rudy, B. J., Murphy, D. A., Harris, D. R., Muenz, L., & Ellen, J. (2009). Patient-related risks for nonadherence to antiretroviral therapy among HIV infected youth in the United States: A study of prevalence and interactions. AIDS Patient Care and STDs, 23(3), 185–194.

    Article  PubMed  Google Scholar 

  • Salamon, K. S., Hains, A. A., Fleischman, K. M., Davies, W. H., & Kichler, J. (2010). Improving adherence in social situations for adolescents with type 1 diabetes mellitus (T1DM): A pilot study. Primary Care Diabetes, 4(1), 47–55.

    Article  PubMed  Google Scholar 

  • Schrag, S. J., Peña, C., Fernández, J., Sánchez, J., Gómez, V., Pérez, E., et al. (2001). Effect of short-course, high-dose amoxicillin therapy on resistant pneumococcal carriage: a randomized trial. JAMA: The Journal of the American Medical Association, 286(1), 49–56.

    Article  Google Scholar 

  • Sherbourne, C. D., Hays, R. D., Ordway, L., DiMatteo, M. R., & Kravitz, R. L. (1992). Antecedents of adherence to medical recommendations: Results from the medical outcomes study. Journal of Behavioral Medicine, 15(5), 447–468.

    Article  PubMed  Google Scholar 

  • Sherbourne, C. D., Wells, K. B., Meredith, L. S., Jackson, C. A., & Camp, P. (1996). Comorbid anxiety disorder and the functioning and well-being of chronically ill patients of general medical providers. Archives of General Psychiatry, 53, 889–895.

    Article  PubMed  Google Scholar 

  • Simmons, L. E., Logan, D. E., Chastain, L., & Cerullo, M. (2010). Engagement in multidisciplinary interventions for pediatric chronic pain: Parental expectations, barriers, and child outcomes. The Clinical Journal of Pain, 26(4), 291–299.

    Article  Google Scholar 

  • Simon, G., Ormel, J., VonKorff, M., & Barlow, W. (1995). Health care costs associated with depressive and anxiety disorders in primary care. The American Journal of Psychiatry, 152, 352–357.

    PubMed  Google Scholar 

  • Thomas, A. M., Peterson, L., & Goldstein, D. (1997). Problem solving and diabetes regimen adherence by children and adolescents with IDDM in social pressure situations: A reflection of normal development. Journal of Pediatric Psychology, 22(4), 541–561.

    Article  PubMed  Google Scholar 

  • Van Es, S. M., Nagelkerke, A. F., Colland, V. T., Scholten, R. J. P. M., & Bouter, L. M. (2001). An intervention programme using the ASE-model aimed at enhancing adherence in adolescents with asthma. Patient Education and Counseling, 44(3), 193–203.

    Article  PubMed  Google Scholar 

  • Walders, N. W., Drotar, D., & Kercsmar, C. (2000). An interdisciplinary intervention for undertreated pediatric asthma. Chest, 129, 292–299.

    Article  Google Scholar 

  • Weissberg-Benchell, J., Glasgow, A. M., Tynan, W. D., Wirtz, P., Turek, J., & Ward, J. (1995). Adolescent diabetes management and mismanagement. Diabetes Care, 18, 77–82.

    Article  PubMed  Google Scholar 

  • World Health Organization. (2003). Adherence to long-term therapies evidence for action. Geneva, Switzerland: Eduardo Sabaté.

    Google Scholar 

  • Wysocki, T., Greco, P., & Buckloh, L. M. (2003). Childhood diabetes in psychological context. In M. C. Roberts (Ed.), Handbook of pediatric psychology (3rd ed.). New York: Guilford Publications, Inc.

    Google Scholar 

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Correspondence to M. Robin DiMatteo Ph.D. .

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DiMatteo, M.R., Miller, T.A. (2013). Treatment Adherence in Adolescence. In: O'Donohue, W., Benuto, L., Woodward Tolle, L. (eds) Handbook of Adolescent Health Psychology. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6633-8_24

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