Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions

Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions

Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions

Promoting Adherence to Medical Treatment in Chronic Childhood Illness: Concepts, Methods, and Interventions

Synopsis

Based on a conference that assembled experts in the field of pediatric compliance in chronic illness, this book presents the latest data and conceptual models of adherence to treatment and recommendations for new directions in the field. Interdisciplinary in approach, the contributors represent a broad array of disciplines, including anthropology, pediatrics, psychology, and sociology. Designed to address critical gaps in the understanding of adherence/compliance to treatment regiments for children with chronic health conditions, this book reviews: *conceptual models used to define adherence treatment and conduct research; *the influences on treatment adherence to chronic illness in children; *the impact of adherence to treatment on children's health and psychological development; *strategies of interventions to promote adherence and reduce noncompliance rates; *methodological and measurement problems in the assessment of treatment adherence; and *recommended research priorities for the measurement of adherence and applications of interventions and training in the treatment of pediatric chronic illness.

Excerpt

The need for this volume arose from several sources. Large numbers of children and adolescents are affected by chronic physical illnesses (Newacheck &Halfon, 1998; Newacheck &Taylor, 1992). Optimal management of such conditions and reduction of associated morbidity require children and families to adhere to demanding treatment regimens. At the same time, there is widespread recognition that patient and family noncompliance with treatment regimens for pediatric chronic illness is an important clinical problem that can lead to unnecessary hospitalizations, increased risk for illness-related complications, and increased medical care costs.

Moreover, recent trends in medical care have increased the significance of patient compliance as a clinical problem. Although advances in medical technology have resulted in potentially more effective treatments for some chronic conditions, some have increased the necessity for more intensive medical management and hence problems in compliance. For example, technologies such as blood glucose monitoring are now available to help children with diabetes to conduct intensive treatment, which has been shown to decrease the rate of complications in this condition (Diabetes Control and Complications Trial Research Group, 1993). However, intensive treatment regimens are much more demanding on children and families and more difficult to follow than traditional approaches. Moreover, shorter duration of hospital stays and limitations on the amount of time practitioners can spend with their patients have shifted increasing but-

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