Compliance with Medical Regimens During Adolescence

Litt, Iris F.; Cuskey, Walter R.

doi:10.1016/s0031-3955(16)33815-9

Cited by 123 publications

(40 citation statements)

References 36 publications

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“…On the other had, higher age was significantly associated with non-adherence (P=0.046) in children with ALL as reported by a score of 2 or more (self-reported method) and with non-adherence (P=0.027) as identified by the metabolites method. This coincides with previous studies that recognised adolescents as the worst compliers in the paediatric age range [24]. …”

Section: Investigation Of Demographic Factors Affecting Adherence To supporting

confidence: 93%

The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia—an exploratory study

Hawwa

Millership²,

Collier³

et al. 2009

Eur J Clin Pharmacol

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Section: Investigation Of Demographic Factors Affecting Adherence To supporting

confidence: 93%

The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia—an exploratory study

Hawwa

Millership²,

Collier³

et al. 2009

Eur J Clin Pharmacol

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“…However, others previously noted that no consistent relationship between adherence and sociodemographic factors was shown to exist in the pediatric population. 4,19 The observation that all the patients who were clinically nonadherent were classified as "full PTSD" seems to suggest that only patients who suffer from symptoms of PTSD are nonadherent. This striking result is probably an artifact of the small sample size (we hypothesize that some, not all, cases of nonadherence may be related to symptoms of PTSD).…”

Section: Discussionmentioning

confidence: 99%

A Pilot Study of Posttraumatic Stress and Nonadherence in Pediatric Liver Transplant Recipients

et al. 2000

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ABSTRACT. Background. Symptoms of posttraumatic stress disorder (PTSD) were described in survivors of life-threatening diseases, the trauma being the experiences associated with the disease or its treatment. Their prevalence in liver transplant recipients is unknown. Based on clinical observations, we hypothesize that a significant proportion of pediatric liver transplant recipients suffers from PTSD symptoms. We further hypothesize that nonadherence (noncompliance) to medical management may, in some cases, be associated with these symptoms. Traumatized patients, according to this hypothesis, will avoid taking their medications, because these serve as painful reminders of the disease.Objectives. To determine the prevalence of PTSD symptoms in a sample of pediatric liver transplant recipients. To determine whether symptoms of PTSD are associated with nonadherence in these patients. To describe the clinical presentation of PTSD and the management of severe nonadherence in patients who suffer from this disorder.Methods. Nineteen pediatric liver transplant recipients and their caretakers were interviewed, using the UCLA Post Traumatic Stress Disorder Reaction Index (PTSRI). Data were obtained on a few demographic parameters and perception of disease threat. Adherence was evaluated by 2 methods: 1) a clinician panel (taking into account the clinical sequelae of severe nonadherence); and 2) computation of the standard deviations (SDs) of consecutive determinations of blood levels of Tacrolimus (a higher SD means higher variability between individual measures and is therefore an indicator of nonadherence). As an illustration of the general phenomenon, we describe 3 cases of liver transplant recipients who were nonadherent and who suffered from PTSD.Results. Six of 19 patients had positive scores on all 3 components of the PTSRI (PTSD patients). Three of these, and none of the others, were considered significantly nonadherent by the panel. Therefore, nonadherence was significantly associated with the existence of symptoms from all 3 domains of PTSD (Fisher's exact test) in our sample. In particular, a high avoidance score on the PTSRI was highly correlated with panel-determined nonadherence. Further, SD of medication levels were significantly higher in PTSD patients, compared with the rest of our sample. No significant differences were found in perception of disease threat or demographic variables between PTSD patients and the rest of our sample. The 3 cases that we describe became adherent to their medications when symptoms of PTSD subsided during the course of therapy.Conclusions. Clinically significant nonadherence, determined by 2 different methods, was associated with the full spectrum of PTSD symptoms in this sample. It was especially associated with a high avoidance score, which suggests that avoidance of reminders of the disease (eg, medications) may be a mechanism of nonadherence. Screening for and management of these symptoms, therefore, may improve adherence. This novel concept may be applicable to other pati...

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“…Compliance can be defined as the extent to which an individual's behavior coincides with medical advice (36,68). Compliance rates vary widely, probably depending on the numerous factors that can influence the decision to comply.…”

Section: Running Shoe Program Surveymentioning

confidence: 99%

“…Compliance rates vary widely, probably depending on the numerous factors that can influence the decision to comply. Overall compliance rates are about 50%, with a range of 20% to 80% (35,36,68). Most of these studies involve taking prescribed medications, and the purchase of a running shoe is a much more complex behavior.…”

Section: Running Shoe Program Surveymentioning

confidence: 99%

Evaluation of Injury Rates During Implementation of the Fort Drum Running Shoe Injury Prevention Program

Knapik¹,

Feltwell²,

Canham-Chervak³

et al. 1999

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Compliance with Medical Regimens During Adolescence

Cited by 123 publications

References 36 publications

The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia—an exploratory study

The development of an objective methodology to measure medication adherence to oral thiopurines in paediatric patients with acute lymphoblastic leukaemia—an exploratory study

A Pilot Study of Posttraumatic Stress and Nonadherence in Pediatric Liver Transplant Recipients

Evaluation of Injury Rates During Implementation of the Fort Drum Running Shoe Injury Prevention Program

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