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Journal of Pediatric Psychology 15(4) pp. 571-579, 1990
© 1990 Society of Pediatric Psychology

other

Pediatric Appointment Keeping: Improving Adherence in a Primary Care Allergy Clinic1

Jack W. Finney2, Kathleen L. Lemanek, Christopher J. Brophy and Michael F. Cataldo

Virginia Polytechnic Institute and State University, Children's Hospital of Philadelphia, George Washington University, Johns Hopkins University School of Medicine and The Kennedy Institute

2All correspondence should be sent to Jack W. Finney, Child Study Center, Department of Psychology, Virginia Polytechnic Institute and State University, Blacksburg, Virginia 24061-0436

We evaluated the effects of introducing and discontinuing an intervention designed to improve adherence with scheduled appointments in a pediatric allergy clinic. Five nonadherent and three adherent patients received reminders and incentives for keeping their scheduled appointments. Adherence with appointments increased for three of the five nonadherent children, who had an average increase of 13%, and adherent patients continued to keep appointments during the intervention condition. After 10 scheduled allergy clinic appointments had been kept, incentives were discontinued while reminders continued. Improvements in adherence were not maintained after incentives were discontinued and two children showed reductions in adherence to below-baseline levels. Incentive programs increase appointment keeping, but discontinuing incentives abruptly may result in the return of nonadherence, even when reminders are provided as a maintenance strategy. Future pediatric psychology research and practice should investigate both the benefits and limitations of strategies designed to improve adherence.

Key words: adherence; allergy; appointment keeping; behavioral pediatrics.


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