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 24 November 2017

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News

IBD medication adherence is low in dysfunctional families

November's issue of Inflammatory Bowel Diseases shows that family dysfunction and poor child coping strategies are associated with worse adherence, and adherence should be monitored where appropriate child discipline is lacking.

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Dr Laura Mackner and colleagues examined reports of adherence to oral medications.

The researchers also assessed parent-child concordance in reports of adherence.

In addition, the research team evaluated factors associated with poor adherence in adolescents with inflammatory bowel disease (IBD).

Participants were 50 children with IBD 11 to 17 years of age, and the study included their parents.

Parents completed an adherence interview and the Child Behavior Checklist, Family Assessment Device, and demographics questionnaires.

Separately, adolescents completed the adherence interview, and the Piers Harris Self-Concept Scale.

The team also gave the adolescents the Children's Depression Inventory, and Coping Strategies Inventory questionnaires.

38% of parents reported being always adherent to all medications
Inflammatory Bowel Diseases

The treating gastroenterologists of participating children completed the Pediatric Crohn's Disease Activity Index during a clinic visit.

This index was completed within a week of completion of the questionnaires.

The researchers found that the mean parent- and child-reported adherence scores fell between the "most of the time" and "always" categories.

However, the research team noted that perfect adherence was low.

Among IBD-specific medications, the team observed that 48% of children and 38% of parents reported being always adherent to all medications.

Parent-child concordance was high.

The team noted that family dysfunction and poor child coping strategies were associated with worse adherence.

The correlation between more behavioral/emotional problems and lower adherence approached significance.

Dr Mackner's team concluded, “Adherence should be monitored in families that lack appropriate child discipline and in children who cope by simply wishing stressors would go away.”

“Because these issues are associated with poor adherence, it has been suggested that psychotherapy addressing these areas may contribute to improved adherence.”

Inflamm Bowel Dis 2005: 11(11): 1006-12
25 October 2005

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