Journal of Pediatric Psychology, Vol. 26, No. 5, 2001, pp. 253-275
© 2001 Society of Pediatric Psychology
Empirically Supported Treatments in Pediatric Psychology: Regimen Adherence
1 Ohio Sate University College of Medicine, 2 University of Kansas, 3 University of Washington School of Medicine
All correspondence should be sent to Kathleen L. Lemanek, Department of Psychology, Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205. E-mail: lemanekk{at}chi.osu.edu .
Objective: To review empirical studies of psychological interventions for nonadherence to medical regimens for three chronic illnesses: asthma, juvenile rheumatoid arthritis (JRA), and type 1 diabetes.
Methods: The Chambless criteria for "promising," "probably efficacious," or "well-established" were applied to 8 intervention studies on asthma, 4 on JRA, and 11 on type 1 diabetes.
Results: For asthma, organizational strategies appear probably efficacious in promoting adherence, whereas educational and behavioral strategies appear promising. For JRA, behavioral strategies appear probably efficacious in improving adherence. For type 1 diabetes, multicomponent packages and operant learning procedures appear probably efficacious, whereas cognitive-behavioral strategies appear promising. No interventions were identified as "well-established."
Conclusions: Future studies will need to develop adequate definitions of adherence, accurate methods of assessing adherence, and appropriate designs to evaluate multicomponent treatment programs to advance interventions to the "well-established" category.
Key words: intervention; nonadherence; asthma; JRA; type 1 diabetes; review.
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