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Dynamic Adhesion Assay for the Functional Analysis of Anti-adhesion Therapies in Inflammatory Bowel Disease
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Identifying youth nonadherence in clinical settings: data-based recommendations for children and adolescents with

Rachel Neff Greenley1, Jennifer Hauser Kunz, Vincent Biank

  • 1Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois 60064, USA. rachel.greenley@rosalindfranklin.edu

Inflammatory Bowel Diseases
|June 13, 2012
PubMed

Insights

Patient self-report is unreliable for tracking pediatric inflammatory bowel disease (IBD) medication adherence. Asking youth about their role in remembering daily medications is a better indicator of adherence than self-recall.

Area of Science:

  • Pediatric Gastroenterology
  • Adherence Research
  • Digital Health

Background:

  • Pediatric inflammatory bowel disease (IBD) management relies on consistent medication adherence.
  • Assessing adherence in pediatric IBD is challenging, with patient self-report often used.
  • Objective measures are needed to validate self-reported adherence data.

Purpose of the Study:

  • To evaluate the accuracy of patient self-reported thiopurine adherence against electronic monitoring in pediatric IBD.
  • To determine if youth and maternal involvement in medication management predicts adherence.
  • To identify more effective methods for screening nonadherence in pediatric IBD.

Main Methods:

  • Fifty-one pediatric IBD patients (ages 11-18) used electronic monitoring (MEMS) for 6 months.
  • Self-report and caregiver involvement in medication reminders were assessed via questionnaires and interviews.
  • Participants were classified as adherent (≥80% adherence via MEMS) or nonadherent.

Main Results:

  • Nonadherent youth overestimated adherence by 23%; adherent youth overestimated by only 2%.
  • Patient self-report showed limited utility in identifying nonadherent youth.
  • High youth involvement in remembering medications decreased nonadherence risk by eightfold.

Conclusions:

  • Clinicians should reconsider screening methods for nonadherence in pediatric IBD.
  • Inquiring about youth involvement in medication reminders is more effective than weekly recall for identifying nonadherence risk.
  • Objective adherence monitoring and caregiver involvement are key factors in pediatric IBD management.
Abstract

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