IMPACT OF TREATMENT ADHERENCE
ON CHILD HEALTH OUTCOMES
AND RESEARCH FINDINGS
Contributors to this section consider the implications of the impact of treatment noncompliance on children's health and well-being as well as research findings. Although the prevalence of treatment nonadherence in populations of children with chronic health conditions has been documented, the impact of treatment adherence on children's health and quality of life is much less understood. In chapter 12, Varni and his colleagues present a conceptual model to guide understanding of the impact of patient adherence on children's health-related quality of life. In this model, background factors such as age, gender, family composition, and illness-related factors such as diagnosis and severity are hypothesized to contribute to the development of health-related quality of life and skills in problem solving and coping.
Varni et al. (chap. 12) derive the hypothesis that adherence to chronic treatment is affected by health-related knowledge, attitudes and skills, and problem solving. One of the specific contributions of this model is to highlight the importance of practices of the health care team, including communication, quality improvement strategies, and treatment care paths and management plans. Children's quality of life is expected to be influenced by their physical symptoms as well as the practices of the health care team. Varni and colleagues articulate the importance of health-related quality of life as an indicator of child health. They argue that it may be a more important outcome measure of treatment effectiveness than either clinical or biomedical outcomes. In this model, one of the goals of health care is to