Identifying youth nonadherence in clinical settings: data-based recommendations for children and adolescents with inflammatory bowel disease. Inflamm Bowel Dis 2012 Jul;18(7):1254-9
Date
06/13/2012Pubmed ID
22689633DOI
10.1002/ibd.21859Scopus ID
2-s2.0-84858420657 (requires institutional sign-in at Scopus site) 41 CitationsAbstract
BACKGROUND: To examine the validity of patient self-report of thiopurine adherence in pediatric inflammatory bowel disease (IBD) against an objective electronic monitoring adherence measure, and to investigate the role of youth and maternal involvement in remembering to take daily medications as predictors of medication adherence.
METHODS: Fifty-one youths with IBD, ages 11-18 years, participated. Youths completed questionnaire assessments of their own and their maternal caregiver's involvement in remembering to take daily medications at baseline, completed monthly interviews assessing thiopurine adherence over the past week for a period of 6 months, and utilized a Medication Events Monitoring System (MEMS) electronic monitor for their thiopurine medication for 6 months. Participants were grouped into adherent (at least 80% of doses taken based on objective MEMS caps) or nonadherent for analyses.
RESULTS: Youths who were nonadherent based on electronic monitoring overestimated their adherence by 23%, whereas adherent youths overestimated their adherence by only 2%, and as such patient self-report offered little utility in identifying youths who were nonadherent. Youths who reported high levels of involvement in remembering to take their medications were nearly eight times less likely to be nonadherent.
CONCLUSIONS: The current findings provide evidence that clinicians who work with children and adolescents with IBD may benefit from modifying their approach to nonadherence screening. Asking about youth involvement in remembering daily medications may be more informative than asking them to recall their medication-taking behavior over the last week in identifying those at highest risk for nonadherence.
Author List
Greenley RN, Kunz JH, Biank V, Martinez A, Miranda A, Noe J, Telega G, Tipnis NA, Werlin S, Stephens MCAuthors
Adrian Miranda MD Adjunct Professor in the Pediatrics department at Medical College of WisconsinJoshua D. Noe MD Associate Dean, Professor in the Pediatrics department at Medical College of Wisconsin
Grzegorz W. Telega MD Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdolescentCaregivers
Child
Databases, Factual
Drug Monitoring
Family
Female
Humans
Immunosuppressive Agents
Inflammatory Bowel Diseases
Male
Medication Adherence
Mercaptopurine
Patient Compliance
Practice Guidelines as Topic
Prognosis
Self Report
Surveys and Questionnaires
