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Published on: September 20, 2018
Behavioral Functioning and Treatment Adherence in Pediatric Inflammatory Bowel Disease: Review and Recommendations
Kevin A Hommel1, Lee A Denson, Wallace V Crandall
1Assistant Professor of Pediatrics in the Division of Behavioral Medicine and Clinical Psychology at the University of Cincinnati College of Medicine and is affiliated with the Center for the Promotion of Treatment Adherence and Self-Management at the Cincinnati Children's Hospital Medical Center, both in Cincinnati, Ohio.
Insights
Behavioral issues in pediatric inflammatory bowel disease (IBD) can negatively impact treatment adherence. This review offers clinical recommendations for assessing and managing behavioral challenges in children and adolescents with IBD.
Area of Science:
- Pediatric Gastroenterology
- Child and Adolescent Psychiatry
- Behavioral Medicine
Background:
- Inflammatory bowel disease (IBD) presents unique challenges for pediatric patients and their families.
- Behavioral functioning is increasingly recognized as a critical factor in managing chronic illnesses.
Purpose of the Study:
- To review research on behavioral functioning and treatment adherence in pediatric IBD.
- To explore how behavioral dysfunction affects adherence to IBD treatments.
- To provide clinical recommendations for assessment and management strategies.
Main Methods:
- An updated literature review focusing on pediatric IBD was conducted.
- Existing research across various chronic conditions was analyzed for relevant insights.
- Evidence regarding the impact of behavioral problems on disease management was synthesized.
Main Results:
- Behavioral problems in patients and families can adversely affect disease management in pediatric IBD.
- A strong link exists between behavioral dysfunction and suboptimal treatment adherence.
- Multimethod assessment and routine screening are crucial for identifying behavioral difficulties.
Conclusions:
- Early identification and intervention for behavioral issues are essential for improving treatment adherence in pediatric IBD.
- Clinical strategies should include open communication between patients, families, and providers.
- Transitioning disease management responsibility from parents to adolescents requires careful attention.
Abstract:
The purpose of this article is to review the existing research pertaining to behavioral functioning and treatment adherence in children and adolescents with inflammatory bowel disease (IBD), discuss potential effects of behavioral dysfunction on adherence, and provide clinical recommendations for assessment and treatment options. An updated literature review in pediatric IBD is presented, and research across chronic conditions supports the plausibility of negative consequences of patient and family behavioral problems on disease management. Clinical recommendations include use of multimethod assessment of treatment adherence, routine screening for behavioral difficulties, patient-provider discussion of behavioral issues and disease management during clinic visits, and increased attention to the process of gradually transitioning responsibility of disease management from parents to adolescents as patients approach adulthood.
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