Adherence to Pediatric Medical Regimens

Description

The third edition of this book provides comprehensive coverage of pediatric medical adherence, including such important topics as the extent of nonadherence and medical consequences, predictors of adherence, theories about adherence and clinical applications, and assessment strategies for adherence and health outcomes. In addition, chapters describe strategies for improving adherence, review research studies on improving adherence, and address ways to improve research on adherence for children and adolescents with chronic diseases. The new edition also examines the developmental aspects of adherence assessment and intervention as well as cultural, ethical, and legal issues in adherence research and practice. Key areas of coverage include:Consequences of nonadherence and correlates of adherence.Developmental aspects related to assessing and improving pediatric medical adherence.Assessing pediatric disease and health status.Cultural, ethical, and legal issues related to pediatric medical adherence. Adherence to Pediatric Medical Regimens, Third Edition, is an essential reference for researchers, professors, and graduate students as well as clinicians, therapists, and other practitioners in developmental, clinical child and school psychology, child and adolescent psychiatry, pediatrics and pediatric psychology, social work, public health, health psychology, and all interrelated fields. Preface Contents Chapter 1: Definitions of Adherence, Types of Adherence Problems, and Adherence Rates The Problem of Adherence Definitions Types of Adherence Problems Adherence Rates to Chronic Disease Regimens References Supplemental Reference List for Table 1.1 Chapter 2: Consequences of Nonadherence and Correlates of Adherence Consequences of Nonadherence Health and Medical Outcomes Quality of Life Cost-Effectiveness of Medical Care Clinical Decisions Clinical Trials Correlates of Adherence to Medical Regimens Patient/Family Correlates Demographics Knowledge Patient Adjustment and Coping Family Adjustment and Coping Parental Involvement/Monitoring Reported Barriers Disease-Related Correlates Duration Course Symptoms/Disease Severity Perceived Severity Regimen-Related Correlates Type and Complexity Costs Side Effects Efficacy Clinical Implications Related to Adherence Correlates References Chapter 3: Adherence Theories: Review, Critique, and Clinical Implications Importance of Theories in Clinical and Research Activities The Health Belief Model Description Critical Appraisal Clinical Implications of the HBM Social Cognitive Theory (Self-Efficacy) Description Critical Appraisal Clinical Implications of SCT (Self-Efficacy) The Theory of Reasoned Action/Planned Behavior Description Critical Appraisal Clinical Implications of the TRA/PB Transtheoretical Model Description Critical Appraisal Clinical Implications of the TTM Applied Behavior Analytic Theory Description Critical Appraisal Clinical Implications of ABA Theory Summary and Implications of Adherence Theories References Chapter 4: Developmental Considerations in Assessing and Improving Adherence Developmental Stages Youth Cognitive Factors Related to Adherence Perception of Their Health Condition Understanding Medical Information Appreciating Consequences Associated with Care Recognizing and Reporting Symptoms Reporting Accurately on Adherence Behaviors Making Medical Decisions and Ability to Self-Regulate Implications for Assessment of Adherence and Related Factors Developmental Trends for Adherence Rates Emotional and Psychological Factors Peer Influence Factors Family Functioning Factors Implications for Designing Adherence-Promotion Interventions Optimizing Provider Communication Obtaining Partnership with Youth for Shared Decision-Making Encouraging Parental Supervision and Involvement Paternal Involvement Parent-Child Agreement Regarding Responsibility Addressing the Transfer of Responsibility from Parents to Youth Promoting Transition Readiness Engaging Youth as Key Stakeholders in Intervention Development References Chapter 5: Assessing Adherence and Methodological Considerations Why Assess Adherence? Screening and Diagnosis Prediction Intervention Selection Evaluation of Intervention Efforts What to Assess? Guidelines for Selecting Target Regimen Behaviors Who Should Be Assessed and Who Should Assess? How to Assess Adherence? Therapeutic Drug Monitoring Description Advantages Disadvantages Electronic Monitors Description Advantages Disadvantages Pharmacy Refill Measures Description Advantages Disadvantages Pill Counts Description Advantages Disadvantages Observation Description Advantages Disadvantages Provider Estimates Description Advantages Disadvantages Patient and Caregiver Reports Description Advantages Disadvantages Comparative Performance of Adherence Measures Methodological Issues and Recommendations for Adherence Measurement Reactivity Representativeness Directness Measurement Standards Interpretation or What’s in a Number? Clinical and Treatment Utility Summary References Untitled Chapter 6: Assessing Disease and Health Outcomes Disease and Health Status Measures Patient-Level Outcomes Micro-level Outcomes Meso-level Outcomes Macro-level Outcomes Methodological Issues and Recommendations for Assessing Disease and Health Measures Choice of Informants Representativeness Generic Versus Disease-Specific Measures Psychometric Standards Limiting “Physiogenic Bias” Clinical Feasibility, Utility, and Relevance Clinical Implications of the Adherence-Outcome Relationship Conclusions References Chapter 7: Review of Adherence Intervention Studies Intervention Studies on Improving Adherence to Regimens for Chronic Pediatric Diseases Meta-Analytic Reviews of Adherence Interventions for Pediatric Medical Regimens Measuring Effectiveness Meta-Analyses of Adherence Interventions for Chronic Pediatric Diseases Asthma Diabetes HIV/AIDS Organ Transplant Mixed Chronic Disease Conclusions from the Meta-Analyses Conclusions and Literature Limitations References Chapter 8: Strategies for Improving Adherence to Pediatric Medical Regimens Educational Strategies for Improving Adherence The “Why?” or Goals of Education The “What?” or Specific Objectives and Content of Education What Is the Diagnosis and Related Information? What Needs to Be Done to Control the Disease? What Are the Potential Negative Side Effects of Treatment? What Are the Benefits of and Strategies for Enhancing Adherence? The “How?” of Educational Strategies Education as an Ongoing Process Effective Verbal Communication Written Communication and Other Media Modeling and Behavioral Rehearsal Summary of Educational Strategies Organizational Strategies for Improving Adherence Increasing Accessibility to Healthcare Consumer-Friendly Clinical Settings Increasing Provider Supervision Simplifying and Minimizing Negative Side Effects of Regimens Using Motivational Interviewing to Enhance Provider/Patient and Family Communication and Relationships Summary of Organizational Strategies Behavioral Strategies for Improving Adherence Parental Monitoring and Supervision Prompting Adherence Adherence Incentives Discipline Strategies Self-Management Strategies Acceptance and Commitment Therapy (ACT) Psychotherapeutic Interventions Summary of Behavioral Strategies Individualizing Interventions: Barriers to Adherence and Functional Analysis Barriers to Adherence Functional Analysis Technology-Based Interventions Conclusions References Chapter 9: Ways to Advance Pediatric Medical Adherence Research Settle on a Standard Definition of Adherence Develop Standard Scores Derived from Adherence Measures and Determine Cutpoints for Classifying People into Adherent and Nonadherent Categories Revise, Rework, and Make Adherence Theories Relevant to Pediatrics Develop Reliable, Valid, Sensitive, and Practical Self-report Measures of Adherence Continue to Develop Electronic Monitor Measures of Adherence, and Extend Them to Regimen Components Other than Medications Develop and Standardize Practical Measures of Disease Activity and Quality of Life Validate Primary and Secondary Interventions to Prevent or Minimize Anticipated Declines in Adherence over Time Make Better Use of Single-Subject Design Methodology for Intervention Studies Develop and Test Innovative Adherence Promotion Strategies and Innovative Ways to Deliver the Interventions Conduct Multi-site, Randomized Controlled Adherence Intervention Trials Calculate Effect Sizes in Our Intervention Studies, and Document the Clinical Significance/Social Validity of Our Research Define, Document, and Minimize Attrition in Research Studies References Chapter 10: Cultural, Ethical, and Legal Issues Involved in Adherence Clinical and Research Activities Cultural Issues Definitions of Culture Why Is Culture Important? Cultural Factors in Clinical Activities Cultural Issues in Research Activities Conclusion Ethical Issues Clinician-Patient Relationship Researcher-Study Participant Relationship Government-Citizenry Relationship Payer-Client Relationship Conclusion Legal Issues Medical Neglect Religious Objections to Medical Care Conclusion References Conclusion: The Inflated Importance of Adherence References Index