Examination of Transition Readiness, Medication Adherence, and Resilience in Pediatric Chronic Illness Populations: A Pilot Study

Abstract

The present study assessed the relationship between resilience, adherence, and transition readiness in adolescents/young adults with chronic illness. Participants included 50 patients (Mean age, Mage = 17.3 ± 2.1 years) diagnosed with an oncology disorder (n = 7; 12.1%), hematology disorder (n = 5; 8.6%), nephrology disorder (n = 31; 53.4%), or rheumatology disorder (n = 7; 12.1%). Patients were administered questionnaires assessing resilience (Conner–Davidson Resilience Scale 25-item questionnaire, CD-RISC-25), transition readiness (Self-Management and Transition to Adulthood with Rx=Treatment, STARx), and self-reported medication adherence (Medication Adherence Module, MAM). Medical chart reviews were conducted to determine objective medication adherence rates based on pharmacy refill history (medication adherence ratios). A multivariate correlation analysis was used to examine the relationship between resilience, transition readiness, and adherence. There was a moderate relationship (r = 0.34, p ≤ 0.05) between resilience (M = 74.67 ± 13.95) and transition readiness (M = 67.55 ± 8.20), such that more resilient patients reported increased readiness to transition to adult care. There also was a strong relationship (r = 0.80, p ≤ 0.01) between self-reported medication adherence (M = 86.27% ± 15.98) and pharmacy refill history (Mean Medication Adherence Ratio, MMAR = 0.75 ± 0.27), which indicated that self-reported adherence was consistent with prescription refill history across pediatric illness cohorts. Our findings underscore the importance of assessing resilience, transition readiness, and adherence years before transitioning pediatric patients to adult providers to ensure an easier transition to adult care.

Adherence in pediatric renal recipients and its effect on graft outcome, a single‐center, retrospective study

“…In conclusion, a closer monitoring of young adolescents and intensive (one‐on‐one) counseling with the patient appears to be crucial. One possibility is the self‐evaluation of transition readiness using a standardized questionnaire (eg, Self‐Management and Transition to Adulthood with Rx = Treatment, STARx) 31,32 . Again, a liaison psychologist rather than the pediatrician could execute this.…”

“…One possibility is the self-evaluation of transition readiness using a standardized questionnaire (eg, Self-Management and Transition to Adulthood with Rx = Treatment, STARx). 31,32 Again, a liaison psychologist rather than the pediatrician could execute this.…”

Adherence to Medication During Transition to Adult Services

“…Interestingly, teenagers who were "ready" were more likely to be white and have a caregiver who was educated past high school, highlighting the potential role of socioeconomic status [19]. Verma and Rohan [20], who studied resilience and transition readiness among pediatric patients with various chronic illnesses, presented similar findings, reporting that neither transition readiness nor resilience was associated with self-reported or actual adherence, as measured by prescription refill data [20].…”

“…Research in populations with pediatric liver transplants, asthma, and IBD have reported conflicting results [17,19,20]. One study looked at the role of transition readiness, specifically readiness to talk with providers and manage daily activities, amongst youth with asthma [19].…”

“…Patients completed a transition readiness questionnaire, which included a medication management scale; lower scores on this scale were associated with greater medication and visit nonadherence, as captured by medical records [ 18 ]. Yet, findings have been equivocal, and the relationship between transition readiness and adherence outcomes may be complicated [ 17 , 19 , 20 ] and related to poorly studied assessments [ 21 ].…”