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White coat adherence over the first year of therapy in pediatric epilepsy

Avani C Modi1, Lisa M Ingerski, Joseph R Rausch

  • 1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA. avani.modi@cchmc.org

The Journal of Pediatrics
|May 22, 2012
PubMed

Insights

Children with epilepsy show "white coat adherence," taking medication more often before doctor visits. This pattern, observed over 13 months, highlights the need for better communication and monitoring in pediatric epilepsy care.

Area of Science:

  • Pediatric Neurology
  • Pharmacology
  • Behavioral Science

Background:

  • Medication adherence is crucial for managing chronic conditions like epilepsy in children.
  • Understanding adherence patterns, such as the
  • white coat adherence
  • phenomenon, is vital for effective treatment.
  • Previous research has not fully explored temporal adherence changes around clinic visits in pediatric epilepsy.

Purpose of the Study:

  • To investigate the phenomenon of
  • white coat adherence
  • in children diagnosed with epilepsy.
  • To analyze how medication adherence changes over time in relation to clinic visits.
  • To assess the implications of adherence patterns for clinical management.

Main Methods:

  • A longitudinal prospective study involving 120 children with newly diagnosed epilepsy and their caregivers.
  • Medication adherence was monitored using electronic monitors over a 13-month period.
  • Ordinal logistic regression models were used to analyze adherence data in relation to clinic visits.

Main Results:

  • Medication adherence significantly increased in the 3 days preceding clinic visits, indicating
  • white coat adherence
  • .
  • Adherence improved following initial clinic visits but declined after the final visit.
  • A significant interaction effect was observed between visit timing and adherence patterns.

Conclusions:

  • The study confirms the presence of
  • white coat adherence
  • in pediatric epilepsy populations.
  • Awareness of this phenomenon is critical for informed clinical decision-making and treatment adjustments.
  • Further research should investigate this in other pediatric groups and develop interventions to improve communication and optimize therapy.
  • Close monitoring of medication patterns can prevent unnecessary treatment modifications.
Abstract

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