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Practice survey: adherence monitoring and intervention in pediatric gastroenterology and hepatology

Authors Maddux MH, Ricks S, Bass JA, Daniel JF, Carpenter E, Radford K

Received 12 December 2017

Accepted for publication 9 April 2018

Published 11 July 2018 Volume 2018:14 Pages 1227—1234

DOI https://doi.org/10.2147/TCRM.S159611

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Cristina Weinberg

Peer reviewer comments 2

Editor who approved publication: Professor Garry Walsh


Michele H Maddux,1,2 Shawna Ricks,2 Julie A Bass,2 James F Daniel,2 Ellen Carpenter,2 Kimberely Radford2

1Division of Developmental and Behavioral Sciences, Children’s Mercy-Kansas City, Kansas City, MO, USA; 2Division of Gastroenterology, Children’s Mercy-Kansas City, Kansas City, MO, USA

Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.
Participants and methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.
Results: Practices varied greatly in terms of when and how patient adherence is monitored and by whom; however, physicians and nursing professionals take primary responsibility for adherence monitoring. Approximately 25% utilize screeners to assess adherence, and most participants use patient and caregiver reports as a primary measure of adherence. Most participants rated their level of adherence monitoring and intervention as fair to poor. While most participants perceive adherence monitoring to be very important in clinical practice, only 20.8% perceive being able to significantly modify patient adherence.
Conclusion: There exists great variability in adherence monitoring and intervention practices across pediatric GI providers. Greater understanding of current adherence practices can inform future clinical efforts.

Keywords: adherence, screening, clinical practice, intervention, compliance

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