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Self-regulation predictors of medication adherence among ethnically different pediatric patients with renal
C M Tucker1, S Petersen, K C Herman
1Department of Psychology, University of Florida, Gainesville 32611, USA. tucker@psych.ufl.edu
Insights
Medication adherence in pediatric renal transplant patients differs by ethnicity. Enhancing self-efficacy may help African American children, while reminders may benefit Caucasian children with medication adherence.
Area of Science:
- Pediatric Nephrology
- Transplantation Medicine
- Health Psychology
Background:
- Medication adherence is critical for pediatric renal transplant recipients.
- Self-regulation variables may influence adherence in this population.
- Ethnic differences in adherence predictors are not well understood.
Purpose of the Study:
- To predict medication adherence in ethnically diverse pediatric renal transplant patients (ages 6-20).
- To examine the role of self-regulation variables: motivation, perceived control, and perceived support.
- To identify ethnic-specific predictors of medication adherence.
Main Methods:
- Verbal administration of the Self-Regulation of Medication Adherence Battery to 26 African American and 42 Caucasian children.
- Assessment of motivation, perceived control/responsibility, and perceived support.
- Medication adherence measured via self-ratings, nephrologist ratings, cyclosporine levels, and pill counts.
Main Results:
- For African American patients, self-efficacy in motivation and perceived control predicted adherence (nephrologist ratings).
- For Caucasian patients, forgetting medication (motivation) predicted self-reported adherence.
- Ethnic differences in adherence predictors were observed.
Conclusions:
- Interventions targeting self-efficacy beliefs may improve adherence in African American pediatric transplant patients.
- Cues and reminders may enhance adherence in Caucasian pediatric transplant patients.
- Results support ethnic-specific approaches to medication adherence research and interventions.
Objective:
To predict medication adherence among ethnically different pediatric patients with renal transplants between the ages of 6 and 20 years old, using self-regulation variables including motivation, perceived control and responsibility, and perceived support.
Methods:
Twenty-six African American children and 42 Caucasian children were verbally administered the Self-Regulation of Medication Adherence Battery to assess their (1) motivation to be medication adherent, (2) perceived control of and responsibility for medication adherence, and (3) perceived support of medication adherence from their primary caregiver. Four measures were used to assess medication adherence: self-ratings, nephrologists' ratings, cyclosporine levels, and pill count/refill histories.
Results:
For the African American patients, regression analyses revealed that responses to motivation and perceived control questions that focused on self-efficacy were unique predictors of medication adherence as rated by their primary nephrologist. For the Caucasian patients, one motivation question regarding how often they forget to take their medication predicted their self-reported adherence.
Conclusions:
Facilitating their beliefs that they can regularly take their medications may help promote medication adherence among African American children with renal transplants, whereas for Caucasian children, providing cues and reminders to take their medications may help. We discuss implications of the results for multimodal assessment of medication adherence and for ethnic group-specific medication adherence research and interventions.
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Kidney Transplant I: Introduction
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