The Effects of Caregiver Social Support and Depressive Symptoms on Child Medication Adherence and Asthma Control

Margolis, Rachel; Dababnah, Sarah; Sacco, Paul; Jones-Harden, Brenda; Bollinger, Mary E.; Butz, Arlene; Bellin, Melissa H.

doi:10.1007/s40615-021-01065-w

Cited by 11 publications

(8 citation statements)

References 42 publications

(58 reference statements)

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“…Anxiety, depression, and declined quality of life often follow, which may indirectly infuence the quality of care they provide, including medication adherence [37,45,46]. In our study, a large proportion of caregivers considered anxiety and depression as one of their barriers to optimal adherence, which was in accordance with previous studies focusing on other pediatric diseases like asthma [20,47]. One potential explanation is that the cognitive impairment caused by depressive emotions, including compromised memory and executive functioning, may contribute to an anxious and depressed caregiver's poor medication adherence administration for their children.…”

Section: Discussionsupporting

confidence: 89%

“…Given these fndings, treating caregivers' anxiety and depression may act as a crucial means of improving pediatric glaucoma control. Some brief, validated tools for screening depressive symptoms, as well as social supports and psychological guidance, should be promoted to disseminate negative emotion for pediatric glaucoma caregivers [20].…”

Section: Discussionmentioning

confidence: 99%

“…Possible barriers to medication adherence of caregivers of children could be very diferent from those of adults, like children's resistance to medication instillation. Tey may also come from caregivers, like caregivers' poor health literacy and depressive emotion [18,20]. However, what specifc barriers of caregivers would be signifcantly associated with poor medication adherence among preschool caregivers of children with pediatric glaucoma and how far they act remained unclear.…”

Section: Introductionmentioning

confidence: 99%

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Medication Adherence and Common Barriers for Caregivers of Preschool Children with Pediatric Glaucoma

Liu

Zhang

et al. 2022

Journal of Ophthalmology

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Purpose. To investigate the medication adherence among caregivers of preschool children with pediatric glaucoma and to elucidate common barriers leading to poor adherence. Methods. A cross-sectional study. Caregivers of preschool children with pediatric glaucoma completed a questionnaire on demographic information of caregivers, demographic and disease characteristics of children, caregivers-reported medication adherence (by an adapted Morisky Adherence Scale), and possible 13 barriers. Results. Overall 132 questionnaires were considered valid. Thirty-six percent of all reported poor medication adherence. Caregivers’ age and self-evaluated knowledge about pediatric glaucoma showed a significant difference between the adherent and nonadherent groups ( P < 0.05 ). Nineteen percent of all reported only one barrier as important, 65% cited multiple barriers, and 16% cited no barriers. Anxiety and depression were cited as important by most caregivers in both groups. Univariate logistic regression analysis demonstrated that difficulty with the acquisition of medications (OR, 2.5; 95% CI, 1.1–5.7; P = 0.025 ), difficulty with medication schedule (OR, 2.3; 95% CI, 1.0–5.0; P = 0.043 ), and high expenses for medications (OR, 4.8; 95% CI, 1.4–15.9; P = 0.011 ) were significantly associated with higher odds of poor adherence. Conclusions. Over one-third of caregivers of preschool children with pediatric glaucoma were in poor medication adherence. Nearly two-thirds of caregivers cited multiple barriers simultaneously as important hindrances to medication usage. Anxiety and depression, difficulty with the acquisition of medications, difficulty with the medication schedule, and high expenses for medications were prominent barriers. Individualized solutions should be provided according to reported barriers by each caregiver and the other most common barriers.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Medication Adherence and Common Barriers for Caregivers of Preschool Children with Pediatric Glaucoma

Liu

Zhang

et al. 2022

Journal of Ophthalmology

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“…While there is not a clear link between food insecurity and FTT/ FG, assessing food insecurity and other social determinants of health may facilitate adherence. Similarly, given the association between mental health conditions such as depression with adherence (Margolis et al, 2021), screening for caregiver mental health may also be important in optimizing treatment adherence for FTT/FG.…”

Section: Discussionmentioning

confidence: 99%

The development of an adherence measure for pediatric failure to thrive/faltering growth.

David¹,

Kiely²,

Kersten³

et al. 2022

Clinical Practice in Pediatric Psychology

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Objective: Failure to thrive/faltering growth (FTT/FG) is often multiply determined and involves caregiver adherence to various recommendations to optimize child weight gain.The current study at an interdisciplinary FTT/FG clinic (a) documented the taxonomy of treatment recommendations made for children with FTT/FG (Study 1) and (b) developed an adherence measure, which was used by trained clinicians to examine the relationship between adherence and weight gain (Study 2). Methods: In Study 1, all treatment recommendations made to caregivers of 102 children with FTT/FG were recorded and categorized into domains. Based on domains identified in Study 1, a seven-domain adherence measure was developed. Using a new sample in Study 2 (n = 131, aged 1 to 10 years), clinicians assessed caregiver adherence to recommendations made at the prior clinic visit and examined the association between adherence and weight gain. Results: From Study 1, clinic recommendations fell within seven domains, including the following four that were expected to be associated with weight gain: liquids, food, behavior, and meal structure. Study 2 found that caregiver adherence, overall, was generally high (M = 3.0, SD = .80, rated on a 0 to 4 scale). Greater overall adherence was associated with greater weight gain (r = .253, p = .02). Examining specific recommendations, adherence to using high-calorie add-ons and limiting long mealtimes were associated with greater weight gain. Conclusions: The adherence measure developed in this study can be used to assist clinicians in the management of FTT/FG. Future research is needed to further identify specific treatment recommendations whose adherence is most closely associated with children's weight gain. Implications for Impact StatementFailure to thrive/faltering growth (FTT/FG), is complex as clinical presentations may vary depending on the child, with a universal goal of increasing weight and growth. Understanding the role of caregiver adherence to recommendations from interdisciplinary providers for FTT/FG has not been explored in the extant literature, and this study developed an adherence measure for this population in an interdisciplinary clinic setting. Overall adherence and adherence to several specific recommendations were significantly associated with greater weight gain, demonstrating a novel application of adherence assessment for children with FTT/FG.

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“…They also identify and remove environmental allergens in the home [ 7 ]. However, many caregivers also face numerous challenges in their daily lives, such as poor general, physical, and mental health [ 8 , 9 , 10 ]. These challenges can affect the caregiver’s ability to provide adequate care for the child, leading to a decline in asthma control.…”

Section: Introductionmentioning

confidence: 99%

Caregivers’ Self-Rated General Health, Physical and Mental Health Status, Disease Morbidity and Association with Uncontrolled Asthma in Children

et al. 2023

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This study examined the association between caregivers’ self-rated general health, poor physical/mental health days, disease morbidity and asthma control in children from the United States with current asthma. The data analyzed for this study were obtained from 7522 children aged 0–17 years who participated in the 2012–2014, 2015–2017, 2018, and 2019 cycles of the Behavioral Risk Factor Surveillance System Asthma Call-back Survey (ACBS). We employed univariate analysis to describe the study population and weighted binary logistic regression to examine the association of predictors with asthma control. Approximately 50% of the children had uncontrolled asthma. The results show that caregivers who reported fair general health had a 61% higher likelihood of reporting uncontrolled asthma in their children compared to those who reported good/very good/excellent health (adjusted odds ratio [aOR] = 1.61; 95% confidence interval [CI], 1.14–2.26). Poor caregiver general health did not reach statistical significance in predicting uncontrolled asthma (aOR = 1.05, 95% CI, 0.62–1.75). Furthermore, having 1 to 14 poor physical/mental health days ([aOR] = 1.70; 95% CI, 1.28–2.227) and ≥15 poor physical/mental health days (aOR = 1.82, 95% CI, 1.31–2.53) was predictive of uncontrolled asthma in children. Additionally, endorsing one reported disease (aOR = 1.49, 95% CI, 1.15–1.93) and ≥2 diseases (aOR = 1.38, 95% CI, 1.08–1.78) was associated with uncontrolled child asthma. These findings underscore the association between caregivers’ self-reported general health, poor mental/physical health days, disease morbidity and uncontrolled asthma among children from the U.S. with asthma. Pediatricians and child health practitioners should recall the importance of this relationship. To facilitate the identification of caregivers at risk and provide more comprehensive and effective care for children with asthma, healthcare practitioners should utilize every child asthma care encounter to inquire about the overall health of caregivers.

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The Effects of Caregiver Social Support and Depressive Symptoms on Child Medication Adherence and Asthma Control

Cited by 11 publications

References 42 publications

Medication Adherence and Common Barriers for Caregivers of Preschool Children with Pediatric Glaucoma

Medication Adherence and Common Barriers for Caregivers of Preschool Children with Pediatric Glaucoma

The development of an adherence measure for pediatric failure to thrive/faltering growth.

Caregivers’ Self-Rated General Health, Physical and Mental Health Status, Disease Morbidity and Association with Uncontrolled Asthma in Children

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