Adherence

Question 1

What is adherence?

Answer 1

The extent to which a persons behavior (including medication-taking) corresponds with agreed recommendations from a healthcare provider

Question 2

What is morbidity?

Answer 2

The state of being symptomatic or unhealthy for disease or condition (many indices of morbidity, like liver disease or hypertension due to obesity. Other indicators of morbidity include hospitalizations due to illness, and emergency room visits due to illness)

Question 3

Be familiar with the different interventions to improve adherence in children.

Answer 3

Educational only (poor emipircal support), behavioral (target anteedents and consequences, most effective when combined with education + cognitive factors), Family Interviews (eduction, problem-solving, communication, cognitive modification), Peer Interventions (limited mixed empirical support), eHealth Interventions (e.g., text message reminds, clinical consultations, limited but growing empirical support, small but sig. overall effect of eHealth interventions on adherence in pediatric asthma patients)

Question 3

Be familiar with the pediatric self-management model.

Answer 3

SMM is the framework for research, practice, and policy. Self-Management Behaviors includes individual, family, community, and healthcare systems.
There is also adherence frequency, which includes treatments (medications, airway clearance, physical therapy, vitamins) and lifestyle modifications (exercise, diet, fluid, sleep).
That then goes to outcomes, which include individual (symptoms, complications, school/work days, drug resistance, mortality, etc.) and system (clinical decision-making, financial costs, treatment efficacy, health care delivery

Question 4

How does adherence change as children get older?

Question 5

Know how duration of disease affects adherence.

Answer 5

Poorer adherence is associated with longer disease duration (and adherence typically declines over time) and higher disease severity/complexity

Question 6

Be familiar with the different adherence assessment methods. (know which method is the gold standard)

Answer 6

Direct observation, Pharamcy record data, pill counts, biological assays, electronic monitoring (THIS IS THE GOLD STANDARD)

Question 7

What are the consequences of poor adherence?

Answer 7

Poorer treatment may include, drug resistance, increased health care and health care utilization, poorer health-related quality