Using communication skills to improve adherence in children with chronic disease: the adherence equation

Area of Science:

• Pediatric chronic disease management
• Health communication
• Medication adherence research

Background:

• Nonadherence to maintenance medication is prevalent in pediatric chronic conditions.
• Existing beliefs suggest nonadherence is therapy-resistant, with limited evidence for successful interventions.
• However, substantial evidence indicates adherence can be improved through specific communication strategies.

Purpose of the Study:

• To outline a framework for improving medication adherence in children with chronic conditions.
• To emphasize the role of communicative consultation skills in achieving treatment concordance.
• To identify key components for enhancing adherence and patient-provider collaboration.

Main Methods:

• The study proposes an 'adherence equation': adherence = follow-up + dialogue + barriers and beliefs + empathy and education => concordance.
• Key strategies include establishing close follow-up for a therapeutic partnership.
• Utilizing collaborative dialogue for self-management education and identifying patient/parental barriers and beliefs.

Main Results:

• Close follow-up and therapeutic partnerships are crucial for establishing trust.
• Collaborative dialogue, rather than unidirectional information, is essential for self-management.
• Identifying and addressing parental illness perceptions and medication beliefs is key to overcoming nonadherence.
• Empathic, evidence-based education can modify these beliefs and perceptions.

Conclusions:

• Medication adherence in pediatric chronic conditions can be significantly improved.
• Applying specific communicative consultation skills, including follow-up, dialogue, and empathy, leads to concordance.
• Achieving concordance results in optimal adherence to collaboratively created treatment plans.