Empirically Supported Treatments in Pediatric Psychology: Regimen Adherence

Lemanek, Kathleen L.; Kamps, Jodi L.; Chung, Natasha Brown

doi:10.1093/jpepsy/26.5.253

Cited by 136 publications

(85 citation statements)

References 42 publications

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“…75 Among children with asthma, juvenile rheumatoid arthritis, and type 1 diabetes, myriad adherence-intervention strategies have been examined. 76 Educational strategies focus on providing written and verbal information to patients and their families about the illness and the regimen requirements, as well as the importance of adherence and anticipatory coping strategies for potential adverse effects. Organizational strategies emphasize simplifying regimens and changing clinic characteristics such as improving supervision of providers, decreasing waiting times, and boosting accessibility.…”

Section: Recommendations For Improving Adherencementioning

confidence: 99%

See 1 more Smart Citation

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Simoni

Montgomery

Martin³

et al. 2007

Pediatrics

197

166

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Although nonadherence to prescribed therapies is widespread, it is particularly problematic with highly active antiretroviral therapy for HIV infection. This review of >50 studies in the area of pediatric HIV infection revealed varying methods for assessing antiretroviral adherence with a wide range of estimates of adherence. Correlates of adherence could be grouped as those relating to the medication, the patient, and the caregiver/family, with many conflicting findings and a lack of theory guiding the research. Only 8 studies, mainly small feasibility or pilot investigations, evaluated highly active antiretroviral therapy adherence interventions in pediatric populations. We conclude with specific recommendations for assessment and clinical management of adherence and discuss directions for future research in this area. KeywordsHIV/AIDS; adherence; compliance; interventions; pediatric Adherence to therapy, or the extent to which a patient's behaviors coincide with medical advice mutually negotiated between the health professional and the patient, is a universal HHS Public Access Author Manuscript Author ManuscriptAuthor ManuscriptAuthor Manuscript challenge with all illnesses and in all age groups. 1 Each year in the United States, 500 000 physicians write 1.8 billion prescriptions involving 55 000 pharmacies. 2 However, many of these prescribed medications are never taken, with rates of nonadherence ranging from 15% to 93%. 3 Among persons with chronic illnesses, nonadherence is especially problematic, occurring in up to 82% of cases. [4][5][6] The effects of nonadherence range from individual disability (eg, unrelieved pain) to global threat (eg, development of treatment-resistant bacteria or viruses). The yearly monetary costs of nonadherence exceed $100 billion. 7Adherence is particularly critical with highly active antiretroviral therapy (HAART) in the treatment of pediatric HIV infection. The data on HAART for pediatric HIV infection, although scarcer than for adults, suggest that medication adherence is a strong predictor of therapeutic impact. 8,9 For example, Wiener et al 10 observed that among children with an HIV-1 RNA viral load (VL) < 10 000, 75% had taken 100% of their medication doses in the previous week, whereas among those with a VL of ≥10 000, only 36% reported taking all of their medication.Despite the benefits of HAART in treating pediatric HIV infection [11][12][13][14][15] and the adverse consequences of nonadherence, adherence is reportedly suboptimal among children. [16][17][18][19][20] It is likely thwarted by multiple barriers 21,22 and complicated because, unlike with many other chronic illnesses, most children who are born with HIV in the United States are ethnic/racial minorities who live in chronic poverty with limited resources and face discrimination, family disruption, substance abuse, and the stressors of life in the inner city. 23 In addition, stigma is greater for HIV/AIDS than other chronic illnesses, which often leads caregivers to conceal the child's diagnosis a...

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Section: Recommendations For Improving Adherencementioning

confidence: 99%

“…A review of the literature in these diseases revealed that "probably efficacious" strategies include organizational interventions, multicomponent packages, and operant learning and that behavioral, educational, and cognitive-behavioral strategies are "promising." 76 …”

Section: Recommendations For Improving Adherencementioning

confidence: 99%

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Simoni

Montgomery

Martin³

et al. 2007

Pediatrics

197

166

View full text Add to dashboard Cite

show abstract

“…An evidence review by Lemanek et al 47 on asthma adherence suggested that some educational and behavioral strategies are "probably efficacious" in creating change. In addition, a study that used cognitive behavioral strategies suggested that diabetic adherence can also be improved.…”

Section: Initial Management Of Adolescent Depressionmentioning

confidence: 99%

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

et al. 2007

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OBJECTIVES. To develop clinical practice guidelines to assist primary care clinicians in the management of adolescent depression. This first part of the guidelines addresses identification, assessment, and initial management of adolescent depression in primary care settings.METHODS. By using a combination of evidence-and consensus-based methodologies, guidelines were developed by an expert steering committee in 5 phases, as informed by (1) current scientific evidence (published and unpublished), (2) a series of focus groups, (3) a formal survey, (4) an expert consensus workshop, and (5) draft revision and iteration among members of the steering committee.RESULTS. Guidelines were developed for youth aged 10 to 21 years and correspond to initial phases of adolescent depression management in primary care, including identification of at-risk youth, assessment and diagnosis, and initial management. The strength of each recommendation and its evidence base are summarized. The identification, assessment, and initial management section of the guidelines includes recommendations for (1) identification of depression in youth at high risk, (2) systematic assessment procedures using reliable depression scales, patient and caregiver interviews, and Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria, (3) patient and family psychoeducation, (4) establishing relevant links in the community, and (5) the establishment of a safety plan.CONCLUSIONS. This part of the guidelines is intended to assist primary care clinicians in the identification and initial management of depressed adolescents in an era of great clinical need and a shortage of mental health specialists but cannot replace clinical judgment; these guidelines are not meant to be the sole source of guidance for adolescent depression management. Additional research that addresses the identification and initial management of depressed youth in primary care is needed, including empirical testing of these guidelines. 4,5 Even when diagnosed by PC physicians, only half of these patients are treated appropriately. 3 Furthermore, rates of completion of specialty mental health referral for youth with a recognized emotional disorder from general medical settings are quite low (J. V. Campo, MD, written communication, 2006).In view of the shortage of mental health clinicians and barriers to children having access to mental health professionals, the well-documented need for PC clinicians to learn how to manage this condition, the increasing evidence base available to guide clinical practice, increased selective serotonin reuptake inhibitor-prescribing rates in pediatric PC, 6,7 and new evidence that a multifaceted approach with mental health consultation may improve the management of depression in PC settings, [8][9][10][11] guidelines may be a necessary first step in the identification and management of depression in adolescents in PC. Unfortunately, no depression-management guidelines have been developed for use in the PC setting in the United S...

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“…Further, poor adherence results in increased morbidity and mortality, as well as problematic medication use and excessive use of health care services. [4,5] Numerous factors have a significant impact on adherence and glycemic control.…”

Section: The Challenges Of Type 1 Diabetesmentioning

confidence: 99%

Contributing Factors to Poor Adherence and Glycemic Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth

McNamara¹,

Reid²,

Freedland³

et al. 2011

Type 1 Diabetes - Complications, Pathogenesis, and Alternative Treatments

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Empirically Supported Treatments in Pediatric Psychology: Regimen Adherence

Abstract: Future studies will need to develop adequate definitions of adherence, accurate methods of assessing adherence, and appropriate designs to evaluate multicomponent treatment programs to advance interventions to the "well-established" category.

Cited by 136 publications

References 42 publications

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Adherence to Antiretroviral Therapy for Pediatric HIV Infection: A Qualitative Systematic Review With Recommendations for Research and Clinical Management

Guidelines for Adolescent Depression in Primary Care (GLAD-PC): I. Identification, Assessment, and Initial Management

Contributing Factors to Poor Adherence and Glycemic Control in Pediatric Type 1 Diabetes: Facilitating a Move Toward Telehealth

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