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Pediatric psychotropic medication initiation and adherence: a literature review based on social exchange theory

Vanya Hamrin1, Erin M McCarthy, Veda Tyson

  • 1Yale University School of Nursing, Yale Univsersity, New Haven, Connecticut, USA. Vanya.Hamrin@yale.edu

Journal of Child and Adolescent Psychiatric Nursing : Official Publication of the Association of Child and Adolescent Psychiatric Nurses, Inc
|August 28, 2010
PubMed

Insights

Family decisions on pediatric psychotropic medication involve weighing benefits like symptom improvement against costs such as side effects and stigma. Adherence is influenced by diagnosis acceptance, education, and provider relationships.

Area of Science:

  • Child and Adolescent Psychiatry
  • Behavioral Health
  • Pharmacology

Background:

  • Psychotropic medication initiation and adherence in children and adolescents is a significant clinical challenge.
  • Understanding family decision-making processes is crucial for effective treatment.
  • Social exchange theory provides a framework for analyzing these decisions.

Purpose of the Study:

  • To explore factors influencing families' decisions regarding psychotropic medication initiation, adherence, and discontinuation in pediatric populations.
  • To examine the costs and benefits associated with psychotropic medication adherence from a family perspective.
  • To evaluate the impact of family demographics and provider relationships on adherence.

Main Methods:

  • A literature review of international and U.S. studies.
  • Databases searched include Medline, CINAHL, and PsycInfo.
  • Social exchange theory was used as a theoretical framework.

Main Results:

  • Medication benefits include symptom improvement, better school performance, and reduced parenting stress.
  • Costs involve adverse effects, stigma, lack of efficacy, and concerns about personality changes.
  • Diagnosis acceptance and provider trust positively impact adherence, while psychosocial alternatives are often preferred.

Conclusions:

  • Family attitudes, beliefs, and perceptions significantly shape medication treatment decisions.
  • Medication psychoeducation has variable effects on adherence.
  • Adolescents gain more influence over adherence decisions as they mature.
Abstract

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