Can You Teach a Teen New Tricks? Problem Solving Skills Training Improves Oral Medication Adherence in Pediatric Patients with Inflammatory Bowel Disease Participating in a Randomized Trial

Greenley, Rachel Neff; Gumidyala, Amitha Prasad; Nguyen, Eve; Plevinsky, Jill M.; Poulopoulos, Natasha; Thomason, Molly Mishler; Walter, Jennifer; Wojtowicz, Andrea A.; Blank, Ellen L.; Gokhale, Ranjana; Kirschner, Barbara S.; Miranda, Adrian; Noe, Joshua D.; Stephens, Michael C.; Werlin, Steven L.; Kahn, Stacy A.

doi:10.1097/mib.0000000000000530

Cited by 47 publications

(71 citation statements)

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“…Patients were excluded from this analytic sample if they were not fluent in English or if they had significant cognitive or communicative impairments that would interfere with completion of study procedures. [22][23][24] Although it was not a specific exclusion criterion, no patients in the parent studies were prescribed corticosteroids at the time of study enrollment.…”

Section: Sample and Participant Selectionmentioning

confidence: 99%

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Walter

Kahn

Noe

et al. 2016

Inflammatory Bowel Diseases

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Section: Sample and Participant Selectionmentioning

confidence: 99%

“…[22][23][24] Participants provided consent/assent during an outpatient pediatric gastroenterology appointment. In the first study, data collection occurred through questionnaire completion in clinic or at home, whereas, in the second study, data collection was completed in-person during home visits.…”

Section: Sample and Participant Selectionmentioning

confidence: 99%

Feeling Fine

Walter

Kahn

Noe

et al. 2016

Inflammatory Bowel Diseases

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“…A total of 808 references were identified, of which eleven articles, reporting nine trials 23,[25][26][27][28][29][30]31,32 were included (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…All except one of the trials were conducted in the USA 23,[25][26][27][28][29][30]32 Seven were randomized controlled trials (RCTs) 23,[25][26][27][28][29][30] and two were non-randomized controlled trials 31,32 . Overall, 521 CA participated in the trials and in most trials parents/carers were involved except for one that included adolescents only 31 .…”

Section: Inclusion Criteriamentioning

confidence: 99%

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A Systematic Review of Self-Management Interventions for Children and Adolescents With Inflammatory Bowel Disease

Tran

Mulligan

2018

Inflammatory Bowel Diseases

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BackgroundSelf-management of inflammatory bowel disease is complex. Children and adolescents (CA) with inflammatory bowel disease (IBD) often have difficulty with managing aspects of their condition, resulting in treatment non-adherence and impaired psychosocial function. Self-management interventions are developed to help support patients and their parents/carers to effectively self-manage. The aim of this systematic review was to evaluate the efficacy of self-management interventions in children and adolescents with IBD. MethodsThe review was conducted in accordance with PRISMA guidelines. A systematic literature search of the following databases; Medline, Embase, Cochrane, CINAHL and PsychINFO was conducted to identify controlled trials of interventions aiming to enhance IBD self-management in CA. Two reviewers screened articles for inclusion. ResultsNine trials (eleven articles) met the inclusion criteria. Most were underpowered with seven recruiting fewer than 50 participants. The interventions aimed to enhance psychological wellbeing (n=5), medication adherence (n=3) or calcium intake (n=1). There was considerable heterogeneity in intervention content and outcomes assessment. Some benefits were reported in disease activity, adherence and psychological wellbeing but findings were inconsistent. ConclusionsSelf-management is difficult for CA with IBD, however this review identified only a small number of interventions to support self-management, most of which were under-powered and only one that was conducted outside the US. Clinical consensus is required on which self-management activities should be recommended to patients and targeted in interventions and which core outcomes should be assessed.Adequately powered trials of interventions are required to identify how best to support self-management in CA with IBD.Population: CA up to 19 years old with IBD, in line with the World Health Organization definition of adolescence 21 . As many interventions for CA include parents/carers, trials that included parents/carers of CA with IBD were also eligible for inclusion.Intervention: Self-management interventions i.e. interventions that aimed to enhance participants' ability to manage their condition and could include interventions to enhance medication adherence, lifestyle, diet, and coping with emotional and social aspects of living with IBD.Comparator: Treatment as usual, an alternative intervention or a waiting list comparator.Outcomes: Outcomes of interest included clinical, behavioural and psychosocial outcomes.Study design: Controlled trials (randomised and non-randomised). Exclusion Criteria:Studies were excluded if they were: Articles that combined adults and CA with IBD or combined CA with IBD with other chronic diseases but did not report findings for CA with IBD separately.  Observational studies. . Relevant variations of search terms in the database thesauruses and MeSH terms were used. See Supplemental file 1 for the full search strategy. Study selectionRetrieved articles were imported into Endnote ver...

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Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions

Zhou,

Luo,

Xiong

et al. 2024

JAMA Pediatr

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ImportanceProblem-solving skills training (PSST) has a demonstrated potential to improve psychosocial well-being for parents of children with chronic health conditions (CHCs), but such evidence has not been fully systematically synthesized.ObjectiveTo evaluate the associations of PSST with parental, pediatric, and family psychosocial outcomes.Data SourcesSix English-language databases (PubMed, Embase, CINAHL, PsycINFO, Web of Science, and Cochrane Library), 3 Chinese-language databases (China National Knowledge Infrastructure, China Science and Technology Journal Database, and Wanfang), gray literature, and references were searched from inception to April 30, 2023.Study SelectionRandomized clinical trials (RCTs) that performed PSST for parents of children with CHCs and reported at least 1 parental, pediatric, or family psychosocial outcome were included.Data Extraction and SynthesisStudy selection, data extraction, and quality assessment were conducted independently by 2 reviewers. Data were pooled for meta-analysis using the standardized mean difference (SMD) by the inverse variance method or a random-effects model. Subgroup analyses of children- and intervention-level characteristics were conducted.Main Outcomes and MeasuresThe psychosocial outcomes of the parents, their children, and their families, such as problem-solving skills, negative affectivity, quality of life (QOL), and family adaptation.ResultsThe systematic review included 23 RCTs involving 3141 parents, and 21 of these trials were eligible for meta-analysis. There was a significant association between PSST and improvements in parental outcomes, including problem-solving skills (SMD, 0.43; 95% CI, 0.27-0.58), depression (SMD, −0.45; 95% CI, −0.66 to −0.23), distress (SMD, −0.61; 95% CI, −0.81 to −0.40), posttraumatic stress (SMD −0.39; 95% CI, −0.48 to −0.31), parenting stress (SMD, −0.62; 95% CI, −1.05 to −0.19), and QOL (SMD, 0.45; 95% CI, 0.15-0.74). For children, PSST was associated with better QOL (SMD, 0.76; 95% CI, 0.04-1.47) and fewer mental problems (SMD, −0.51; 95% CI, −0.68 to −0.34), as well as with less parent-child conflict (SMD, −0.38; 95% CI, −0.60 to −0.16). Subgroup analysis showed that PSST was more efficient for parents of children aged 10 years or younger or who were newly diagnosed with a CHC. Significant improvements in most outcomes were associated with PSST delivered online.Conclusions and RelevanceThese findings suggest that PSST for parents of children with CHCs may improve the psychosocial well-being of the parents, their children, and their families. Further high-quality RCTs with longer follow-up times and that explore physical and clinical outcomes are encouraged to generate adequate evidence.

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Can You Teach a Teen New Tricks? Problem Solving Skills Training Improves Oral Medication Adherence in Pediatric Patients with Inflammatory Bowel Disease Participating in a Randomized Trial

Abstract: Phone-delivered PSST was feasible and acceptable. Efficacy estimates were similar to those of lengthier interventions conducted in other chronic illness populations. Older adolescents benefited more from the intervention than their younger counterparts.

Cited by 47 publications

References 33 publications

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A Systematic Review of Self-Management Interventions for Children and Adolescents With Inflammatory Bowel Disease

Problem-Solving Skills Training for Parents of Children With Chronic Health Conditions

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