to Medication Treatment
Doreen M. Matsui Children's Hospital of Western Ontario, Canada
Modern research resulting in efficacious drug therapy has improved the outlook for many children with acute or chronic illness. However, for these children to benefit from the available treatments, they must actually take or be given their medication. In recent years, the extent of noncompliance has become increasingly recognized, and efforts have been undertaken to better measure compliance and develop strategies to improve it. Noncompliance, however, is not a new problem, as illustrated by Hippocrates' advice to physicians to "keep watch also on the fault of patients which often make them lie about the taking of things prescribed" ( Tebbi, 1993).
Drug compliance is of particular concern with chronic medical conditions because therapy is often long term and, at times, lifelong. Asymptomatic patients may be required to take medication to prevent later complications without any immediate benefits noted. Both of these factors may make it more difficult for children to continually adhere to their treatment regimens. It is generally agreed that compliance with drug therapy for acute diseases is better than for chronic diseases ( Rapoff & Barnard, 1991).
Evaluation of drug compliance in pediatrics is unique: Whether a younger child receives his or her prescribed medication is determined not only by the patient, but also by the parent--who is often responsible for giving the medication. There may be varying degrees of involvement of the parent in the case of the older child or adolescent. Administration of medication to a child is not always a simple matter because the child, often unaware of the purpose of the medication, may be reluctant to take