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Journal of Pediatric Psychology Advance Access published online on March 11, 2008
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsn022
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© The Author 2008. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

Medication Adherence and Quality of Life in Pediatric Inflammatory Bowel Disease

Kevin A. Hommel, PhD1,2, Christine M. Davis3 and Robert N. Baldassano, MD3,4

1Cincinnati Children's; Hospital Medical Center, 2University of Cincinnati College of Medicine, 3Children's; Hospital of Philadelphia, and 4University of Pennsylvania School of Medicine

All correspondence concerning this article should be addressed to Kevin A. Hommel, PhD, Cincinnati Children's Hospital Medical Center, Center for the Promotion of Treatment Adherence and Self Management, Division of Behavioral Medicine and Clinical Psychology, 3333 Burnet Ave. MLC 7039, Cincinnati, OH 45229, USA. E-mail: kevin.hommel{at}cchmc.org


  Abstract

Objective To examine the relationship between medication adherence and quality of life (QOL) in adolescent patients with inflammatory bowel disease (IBD) utilizing a multimethod adherence assessment approach. Methods Medication adherence in 36 adolescents with IBD was assessed via interviews, pill counts, and biological assays. QOL was assessed via patient and parent report. Pediatric gastroenterologists provided disease severity assessments. Results Hierarchical multiple regression analyses revealed that adherence contributed significant variance to patient-reported QOL but not parent-reported QOL. Nonadherence to 6-MP/azathioprine was related to poorer patient-reported physical health QOL. Greater self-reported 5-ASA adherence was related to poorer overall psychological health QOL, and particularly social functioning QOL. Conclusions Results provide preliminary support for the negative effects of 6-MP/azathioprine nonadherence on QOL and an inverse relationship between 5-ASA adherence and QOL in this population. Adherence burden in patients and the utility of multimethod adherence assessment in research are discussed.

Key words: adherence; compliance; inflammatory bowel disease; quality of life.

Received August 14, 2007; revision received January 23, 2008; accepted February 21, 2008


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