Compliance with Pharmacotherapy in Adolescents: Effects of Patients' and Parents' Knowledge and Attitudes toward Treatment

Bastiaens, Leo

doi:10.1089/cap.1995.5.39

Cited by 23 publications

(17 citation statements)

References 2 publications

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“…When considering medication for children, clinicians need to be attuned to developmental and temperamental issues (18). Bastiens advocates that clinicians consider the efficacy and side effects of medication, whether parents are comfortable giving medication, and whether children are comfortable receiving it (19). Several factors may decrease the likelihood of children receiving psychotropic medication, even when it appears warranted.…”

Section: Prescribing Practices In Childrenmentioning

confidence: 99%

Medicated Anxious Children: Characteristics and Cognitive-Behavioural Treatment Response

Liashko

Manassis

2003

Can J Psychiatry

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A nxiety disorders in children and adolescents are highly prevalent psychopathologies affecting as many as 10% of youth (1-3). These disorders are frequently associated with psychosocial difficulties, school difficulties, and risk for more serious conditions including depression, suicide, and substance abuse. The goals of treatment are to target overwhelming, incapacitating anxiety that interferes with functioning in social or academic spheres and to prevent a chronic Can J Psychiatry, Vol 48, No 11, December 2003 W 741 Objective: To determine whether individual and family characteristics of children with anxiety disorders who take psychotropic medications differ from those that are unmedicated and whether there is a differential response to cognitive-behavioural therapy (CBT). Method:Children ages 8 to 12 years (n = 102: 18 medicated, 84 unmedicated) were recruited in a specialized outpatient clinic over a 3-year period. All had a primary diagnosis of an anxiety disorder. Comparisons were done using t-tests for continuous measures and chi-square tests for discrete measures. Treatment-related changes were assessed using repeated measures analyses of variance.Results: Medicated and unmedicated groups did not differ by age, sex, socioeconomic status, or diagnostic profile. Initial ratings of anxiety symptoms, depressive symptoms, and global functioning were comparable. Greater family dysfunction and family frustration were reported in medicated children. With treatment, both groups improved symptomatically and showed improved family functioning. Families of medicated children showed a greater reduction in frustration than families of unmedicated children, whereas unmedicated children showed greater gains in global functioning. Conclusions:Initial family functioning of medicated children seems to show more disturbances. Both medicated and unmedicated children can benefit from CBT. Further studies of differential treatment effects for medicated and unmedicated children are indicated. Information on funding and support and author affiliations appears at the end of the article. Clinical Implications· Families of children with anxiety disorders who require medications may show higher rates of family dysfunction and family frustration. · Family dysfunction appears to improve with cognitive-behavioural therapy (CBT). · Even anxious children who require medications can benefit from CBT, although gains in global functioning may be more limited. Limitations· This was an exploratory, uncontrolled study without randomization. · Results were not corrected for number of comparisons. · Results must be replicated with the inclusion of more medicated children.

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Section: Prescribing Practices In Childrenmentioning

confidence: 99%

Medicated Anxious Children: Characteristics and Cognitive-Behavioural Treatment Response

Liashko

Manassis

2003

Can J Psychiatry

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“…Medication nonadherence is multifactorial, including failure of patients to take any medications at all, failure to fill their prescriptions (Beardon et al 1993), taking erroneous dosages, consuming prescribed medication at incorrect times, adhering to only part of the medication regimen, or ingesting inappropriate combinations of medications (Blackwell 1992). The pervasiveness of this problem is illustrated by the estimated 50% nonadherence rate for patients taking medications for chronic illnesses (Rudd 1993).…”

Section: Introductionmentioning

confidence: 99%

Rates and Predictors of Adherence with Atypical Antipsychotic Medication: AFollow-Up Study of Adolescent Inpatients

Pogge

Singer

Harvey³

2005

Journal of Child and Adolescent Psychopharmacology

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Failure to continue recommended treatment with atypical antipsychotics was most common in cases who did not comply with other aspects of the discharge plan. Efficacy of the medication did not predict nonadherence, as half of the noncompliant subjects stated that the medication had been helpful. Rapid weight gain also predicted nonadherence, but subjective impression of long-term weight gain was not different across adherence or treatment status. These data tentatively suggest that in adolescent patients, tendencies toward general uncooperativeness and substance abuse may be at least as important as the occurrence of common side effects in the determination of medication adherence.

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“…Estimates of noncompliance rates among adolescents range between 10% and 80%, but most fall somewhere in the middle (Lloyd et al 1998). Empirical research in this area has yet to find consistent predictors of nonadherence to prescribed medication among adolescents, but psychosocial factors such as youths' attitudes toward medication, and the quality of their relationships with family and treatment providers have been anecdotally described as important predictors or correlates of nonadherence rates (e.g., Bastiaens 1995;Cromer and Tarnowski 1989). The more we understand about the psychosocial effects of psychopharmacologic treatment on adolescents the more we may learn about nonadherence, which incurs negative clinical and economic consequences.…”

Section: The Psychosocial Effects Of Medication On Youthmentioning

confidence: 99%

The “Other” Effects of Psychotropic Medication: Social Workers’ Perspectives on the Psychosocial Effects of Medication Treatment on Adolescent Clients

Moses

2008

Child Adolesc Soc Work J

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This study explores social workers' perspectives on the psychosocial effects of psychotropic drug treatment of their adolescent clients. Using a mail survey, we asked a national sample of experienced clinical social workers to answer questions about their perceptions of the effects of such treatment on the sense of self and social well-being of an adolescent client. The survey questions also explored associations between perceived psychosocial medication effects and characteristics of the client and the treatment. The findings suggested that social workers viewed medication treatment as having greater beneficial than harmful psychosocial effects on their adolescent clients, but that both effects existed simultaneously. The most important factors associated with the perceived effects of medication that emerged from social workers' reports included the etiology of the disorder, the type of drug treatment and its effectiveness in addressing symptoms, the client's ''competence,'' and the quality of the relationship between the client and the treating social worker. This study provides direction for future research on a neglected but important question. It would be helpful to broaden the scope of professional discourse on the advantages and disadvantages of psychopharmacologic treatment for youth beyond the effectiveness or safety of the treatment to include questions concerning clinicians' perceptions of the effects of drug treatment on youths' sense of self and social well-being.

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Compliance with Pharmacotherapy in Adolescents: Effects of Patients' and Parents' Knowledge and Attitudes toward Treatment

Cited by 23 publications

References 2 publications

Medicated Anxious Children: Characteristics and Cognitive-Behavioural Treatment Response

Medicated Anxious Children: Characteristics and Cognitive-Behavioural Treatment Response

Rates and Predictors of Adherence with Atypical Antipsychotic Medication: AFollow-Up Study of Adolescent Inpatients

The “Other” Effects of Psychotropic Medication: Social Workers’ Perspectives on the Psychosocial Effects of Medication Treatment on Adolescent Clients

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