Brief Report: Barriers to Treatment Adherence in Pediatric Inflammatory Bowel Disease

Overview

Journal J Pediatr Psychol

Publisher Oxford University Press

Date 2009 Dec 23

PMID 20026567

Citations 32

Authors

Kevin A Hommel

Robert N Baldassano

Affiliations

Soon will be listed here.

Abstract

Objective: To examine perceived barriers to medication adherence in inflammatory bowel disease (IBD) treatment and their relationship with adherence using a combined forced choice and semi-structured interview assessment approach.

Methods: Sixteen adolescents with IBD and their parents participated in an open-ended interview regarding adherence barriers and completed quantitative measures of adherence, barriers to treatment, and disease severity.

Results: The most commonly identified barriers to adherence were forgetting, interference with other activities, difficulty swallowing pills, and not being at home. Number of reported barriers was positively correlated with objective nonadherence for 6-MP/azathioprine. Nonadherence frequency was 42% for 6-MP/azathoprine and 50% for 5-ASA medications.

Conclusions: Using a combined assessment approach, patients and parents reported several barriers to treatment adherence that are appropriate for clinical intervention. This is critical given the significant medication nonadherence observed in this sample and the relationship between total number of barriers and disease management problems.

Citing Articles

Self-Management assistance for recommended treatment (SMART) IBD app randomized control trial in adolescents with IBD: Design and methodology.

Roberts C, Plevinsky J, Gamwell K, Noser A, Denson L, Hommel K Health Care Transit. 2024; 2:100031.

PMID: 39712584 PMC: 11657775. DOI: 10.1016/j.hctj.2023.100031.

A Self-led Self-management Intervention Supporting Teens with IBD (ASSIST-IBD): protocol for a feasibility study of a novel digital treatment adherence intervention.

Screti C, Atkinson L, Shaw R, Muhammed R, Heath G BMJ Open. 2024; 14(10):e085576.

PMID: 39414300 PMC: 11487816. DOI: 10.1136/bmjopen-2024-085576.

A qualitative evaluation of treatment fidelity alongside a pilot trial of a novel therapy for pediatric Inflammatory Bowel Disease.

Olson J, Castillo G, Palumbo A, Harrison M, Singleton R, Lalu M PLoS One. 2024; 19(7):e0292709.

PMID: 39078826 PMC: 11288461. DOI: 10.1371/journal.pone.0292709.

Demystifying a family-based epilepsy adherence problem-solving intervention: Exploring adherence barriers and solutions.

Williford D, Guilfoyle S, Modi A Clin Pract Pediatr Psychol. 2023; 11(1):66-73.

PMID: 36969546 PMC: 10038204. DOI: 10.1037/cpp0000436.

Barriers to medication adherence among adolescents and young adults with cancer.

McGrady M, Ketterl T, Norris R, Perentesis J, Pettee D, Mara C Pediatr Blood Cancer. 2023; 70(3):e30186.

PMID: 36602026 PMC: 11587192. DOI: 10.1002/pbc.30186.

References

Oliva-Hemker M, Abadom V, Cuffari C, Thompson R . Nonadherence with thiopurine immunomodulator and mesalamine medications in children with Crohn disease. J Pediatr Gastroenterol Nutr. 2007; 44(2):180-4. DOI: 10.1097/MPG.0b013e31802b320e. View

Lichtiger S, Present D, Kornbluth A, Gelernt I, Bauer J, Galler G . Cyclosporine in severe ulcerative colitis refractory to steroid therapy. N Engl J Med. 1994; 330(26):1841-5. DOI: 10.1056/NEJM199406303302601. View

Logan D, Zelikovsky N, Labay L, Spergel J . The Illness Management Survey: identifying adolescents' perceptions of barriers to adherence. J Pediatr Psychol. 2003; 28(6):383-92. DOI: 10.1093/jpepsy/jsg028. View

Zelikovsky N, Schast A . Eliciting accurate reports of adherence in a clinical interview: development of the Medical Adherence Measure. Pediatr Nurs. 2008; 34(2):141-6. View

Simons L, Blount R . Identifying barriers to medication adherence in adolescent transplant recipients. J Pediatr Psychol. 2007; 32(7):831-44. DOI: 10.1093/jpepsy/jsm030. View

Hommel K, Davis C, Baldassano R . Objective versus subjective assessment of oral medication adherence in pediatric inflammatory bowel disease. Inflamm Bowel Dis. 2008; 15(4):589-93. PMC: 2663377. DOI: 10.1002/ibd.20798. View

Pieper K, Rapoff M, Purviance M, Lindsley C . Improving compliance with prednisone therapy in pediatric patients with rheumatic disease. Arthritis Care Res. 1989; 2(4):132-5. DOI: 10.1002/anr.1790020407. View

Hommel K, Davis C, Baldassano R . Medication adherence and quality of life in pediatric inflammatory bowel disease. J Pediatr Psychol. 2008; 33(8):867-74. PMC: 2493513. DOI: 10.1093/jpepsy/jsn022. View

Ingerski L, Baldassano R, Denson L, Hommel K . Barriers to oral medication adherence for adolescents with inflammatory bowel disease. J Pediatr Psychol. 2009; 35(6):683-91. PMC: 2902844. DOI: 10.1093/jpepsy/jsp085. View

10.

Otley A, Loonen H, Parekh N, Corey M, Sherman P, Griffiths A . Assessing activity of pediatric Crohn's disease: which index to use?. Gastroenterology. 1999; 116(3):527-31. DOI: 10.1016/s0016-5085(99)70173-3. View

11.

Mackner L, Crandall W . Oral medication adherence in pediatric inflammatory bowel disease. Inflamm Bowel Dis. 2005; 11(11):1006-12. DOI: 10.1097/01.mib.0000186409.15392.54. View

12.

Kappelman M, Rifas-Shiman S, Kleinman K, Ollendorf D, Bousvaros A, Grand R . The prevalence and geographic distribution of Crohn's disease and ulcerative colitis in the United States. Clin Gastroenterol Hepatol. 2007; 5(12):1424-9. DOI: 10.1016/j.cgh.2007.07.012. View

13.

Mackner L, Crandall W . Long-term psychosocial outcomes reported by children and adolescents with inflammatory bowel disease. Am J Gastroenterol. 2005; 100(6):1386-92. DOI: 10.1111/j.1572-0241.2005.41428.x. View

14.

Modi A, Quittner A . Barriers to treatment adherence for children with cystic fibrosis and asthma: what gets in the way?. J Pediatr Psychol. 2006; 31(8):846-58. DOI: 10.1093/jpepsy/jsj096. View

15.

Hyams J, Ferry G, Mandel F, GRYBOSKI J, Kibort P, Kirschner B . Development and validation of a pediatric Crohn's disease activity index. J Pediatr Gastroenterol Nutr. 1991; 12(4):439-47. View

16.

Zelikovsky N, Schast A, Palmer J, Meyers K . Perceived barriers to adherence among adolescent renal transplant candidates. Pediatr Transplant. 2008; 12(3):300-8. DOI: 10.1111/j.1399-3046.2007.00886.x. View