Association of Disease, Adolescent, and Family Factors with Medication Adherence in Pediatric Inflammatory Bowel Disease

Reed-Knight, Bonney; Lewis, Jeffery D.; Blount, Ronald L.

doi:10.1093/jpepsy/jsq076

Cited by 71 publications

(83 citation statements)

References 28 publications

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“…56 Thirdly, we did not record the degree to which parents were involved in the supervision of medication use in this study, which has been associated with better adherence in children. 23 Regarding our follow-up data, because the physicians treating patients were not blinded to the results of thiopurine metabolite testing, it is conceivable that undetectable tioguanine (thioguanine) levels influenced the decisions to escalate treatment and/or refer patients for surgery: although if this was going to bias decisions about medications, it would be to advise them about adherence rather than escalate their treatment.…”

Section: Limitationsmentioning

confidence: 99%

“…17 Thus, the patients labelled young adults herein are older than those reported in paediatric series. [19][20][21][22][23][24] As a result, we have intentionally drawn comparisons throughout this discussion from the adult literature with similar age ranges. Time constraints, medication side effects, poorly controlled disease activity and the perception that the drug is not working, as well as simply forgetting have been cited by young adults with IBD and their parents as reasons for non-adherence.…”

Section: External Validitymentioning

confidence: 99%

“…21,22 In contrast, factors that predict good adherence include shorter disease duration, greater maternal involvement in the medical regimen and higher perceived disease severity. 23 Because this is a cohort from a tertiary centre located in one of the most impoverished areas in the UK, it is probable that we have included patients with more severe disease, and facing more economic hardship, than are seen routinely in other healthcare settings. Thus, it is unknown to what extent our findings are applicable to less severe, for example population-or community-based cohorts.…”

Section: External Validitymentioning

confidence: 99%

“…17,18 The reasons for this have not been investigated, because the body of paediatric and/or adolescent literature has focused on children under the age of 17 years. [19][20][21][22][23][24] However, psychological co-morbidity has been implicated as a potentially reversible cause in children 24 and adults with IBD. 11,16,25,26 On the basis of our previous retrospective observations, 18 we hypothesised that non-adherence, objectively defined using thiopurine metabolite levels, is more common in young adults attending our adolescent transition clinic than adults with IBD and that psychological co-morbidity is a contributing factor.…”

Section: Introductionmentioning

confidence: 99%

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Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Goodhand

Kamperidis

Sirwan

et al. 2013

Aliment Pharmacol Ther

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Section: Limitationsmentioning

confidence: 99%

Section: External Validitymentioning

confidence: 99%

Section: External Validitymentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Goodhand

Kamperidis

Sirwan

et al. 2013

Aliment Pharmacol Ther

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“…For example, since sulfasalazine competitively inhibits folate absorption, patients should be treated simultaneously with folate (Reed-Knight, Lewis, & Blount, 2011). Adherence to folate supplementation and 5-ASA maintenance therapy may reduce the risk of colon cancer .…”

Section: Over-the-counter Medicationsmentioning

confidence: 99%

The role of family nurse practitioners : promoting oral medication adherence to maintenance treatment among adolescents with inflammatory bowel disease

Cui¹

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The role of family nurse practitioners (FNPs) in promoting medication adherence in adolescents with inflammatory bowel disease (IBD) has not been established. This project provides intervention strategies that FNPs can use to promote oral medication adherence to maintenance treatment in adolescents with IBD. This is a critical need because non-adherence to maintenance therapy is the most significant factor associated with relapses of IBD and a serious health issue in adolescents with illD. There are no current best practice guidelines in promoting adherence to maintenance medications in illD patients. Findings from the literature review suggest that non-adherence to maintenance therapy is complex and multi-factorial. No single intervention strategy has been shown to be effective for all patients and conditions. However, individually tailored interventions that attend to behavioural, educational and psychosocial factors appear promising. The bio-psychosocial model is used as a conceptual framework to examine the factors affecting medication adherence and to explore the intervention strategies for improving medication adherence. Findings of this project are limited by the paucity of research on medication adherence in adolescents with illD. Implications and recommendations for family nurse practitioner practice, education and research are discussed.

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International and Interdisciplinary Identification of Health Care Transition Outcomes

et al. 2016

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IMPORTANCE There is a lack of agreement on what constitutes successful outcomes for the process of health care transition (HCT) among adolescent and young adults with special health care needs. OBJECTIVE To present HCT outcomes identified by a Delphi process with an interdisciplinary group of participants. DESIGN, SETTING, AND PARTICIPANTS A Delphi method involving 3 stages was deployed to refine a list of HCT outcomes. This 18-month study (from January 5, 2013, of stage 1 to July 3, 2014, of stage 3) included an initial literature search, expert interviews, and then 2 waves of a web-based survey. On this survey, 93 participants from outpatient, community-based, and primary care clinics rated the importance of the top HCT outcomes identified by the Delphi process. Analyses were performed from July 5, 2014, to December 5, 2014. EXPOSURES Health care transition outcomes of adolescents and young adults with special health care needs. MAIN OUTCOMES AND MEASURES Importance ratings of identified HCT outcomes rated on a Likert scale from 1 (not important) to 9 (very important). RESULTS The 2 waves of surveys included 117 and 93 participants as the list of outcomes was refined. Transition outcomes were refined by the 3 waves of the Delphi process, with quality of life being the highest-rated outcome with broad agreement. The 10 final outcomes identified included individual outcomes (quality of life, understanding the characteristics of conditions and complications, knowledge of medication, self-management, adherence to medication, and understanding health insurance), health services outcomes (attending medical appointments, having a medical home, and avoidance of unnecessary hospitalization), and a social outcome (having a social network). Participants indicated that different outcomes were likely needed for individuals with cognitive disabilities. CONCLUSIONS AND RELEVANCE Quality of life is an important construct relevant to HCT. Future research should identify valid measures associated with each outcome and further explore the role that quality of life plays in the HCT process. Achieving consensus is a critical step toward the development of reliable and objective comparisons of HCT outcomes across clinical conditions and care delivery locations.

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Association of Disease, Adolescent, and Family Factors with Medication Adherence in Pediatric Inflammatory Bowel Disease

Abstract: Interventions for improving adherence in adolescents with IBD should address disease, individual, and family factors with special attention given to adolescents who have been diagnosed longer.

Cited by 71 publications

References 28 publications

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

Factors associated with thiopurine non-adherence in patients with inflammatory bowel disease

The role of family nurse practitioners : promoting oral medication adherence to maintenance treatment among adolescents with inflammatory bowel disease

International and Interdisciplinary Identification of Health Care Transition Outcomes

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