Influences on Adherence to Pediatric Asthma Treatment: A Review of Correlates and Predictors

Abstract

Nonadherence to treatment is an important influence on the health outcomes of children and adolescents with pediatric asthma, which is the most prevalent childhood chronic illness. Because the factors that influence treatment adherence for pediatric asthma are not well understood, a comprehensive review of relevant research is needed. To address this need, research concerning the correlates and predictors of adherence to inhaled corticosteroid treatment for pediatric asthma was reviewed. Significant predictors and correlates of treatment adherence identified in this review were consistent with a conceptual model that included family demographic characteristics and functioning, parent and child characteristics, health care system and provider characteristics, and child health outcomes. Family functioning and parental beliefs about asthma and medication treatment demonstrated consistent relationships with treatment adherence. Future research should test multivariate models of influences on treatment adherence in pediatric asthma in prospective studies using reliable and valid measures of predictors and outcomes. Intervention studies are also needed that target potentially modifiable, empirically supported influences to enhance treatment adherence. The clinical management of pediatric asthma would be enhanced by routine assessment of barriers to treatment adherence and anticipatory interventions that address them to prevent nonadherence.

Adherence: Its Role in Achieving Control Over Bronchial Asthma in Children

“…В целом, непреднамеренное невыполнение реко-мендаций -явление сравнительно редкое [30][31][32]. Осо знание болезни и понимание цели лекарственной терапии родителями и пациентом -важный фактор сле-дования рекомендациям [14].…”

Collaborative decision-making and promoting treatment adherence in pediatric chronic illness

“…However, a growing body of empirical evidence has underscored the limitations of the authoritarian familyprovider relationship described above for pediatric chronic illness management. 7,19 Taken together, empirical evidence underscores a mismatch between the level of provider-family communication and collaborative decision-making that may be necessary to develop and sustain treatment adherence versus what is typically provided within pediatric chronic illness care. 7,19 For example, some adolescents with chronic conditions perceive their communications with their physicians as barriers to their treatment adherence (eg, "I have trouble understanding what the doctor tells me to do for my regimen; doctors are too busy to talk with me about my illness and regimen").…”

“…7,19 Taken together, empirical evidence underscores a mismatch between the level of provider-family communication and collaborative decision-making that may be necessary to develop and sustain treatment adherence versus what is typically provided within pediatric chronic illness care. 7,19 For example, some adolescents with chronic conditions perceive their communications with their physicians as barriers to their treatment adherence (eg, "I have trouble understanding what the doctor tells me to do for my regimen; doctors are too busy to talk with me about my illness and regimen"). 20 Loonen et al 21 identified discrepancies in specific areas of chronic illness management that were ranked as important to adolescents with inflammatory bowel disease compared with those identified by their physicians.…”

“…7,33 If and when providers eventually discover unilateral parental and/or child decisions to omit or take a different dose of medication, submit your manuscript | www.dovepress.com…”

“…Positive provider-patient communication and treatment alliance are very important in adherence promotion. [7][8][9] Collaborative (or shared) decision-making between health care provider and patient in medical treatment 10,11 may promote treatment adherence, satisfaction with medical care, and positive health outcomes. [12][13][14] The overwhelming majority of research and clinical observation concerning collaborative decision-making has focused on the medical treatment of adults and/or on discrete decisions such as whether to participate in medical screening tests, vaccination, or surgery as opposed to decisions related to chronic illness management.…”