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Journal of Pediatric Psychology Advance Access published online on September 23, 2009
Journal of Pediatric Psychology, doi:10.1093/jpepsy/jsp085
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© The Author 2009. 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

Barriers to Oral Medication Adherence for Adolescents with Inflammatory Bowel Disease

Lisa M Ingerski, PhD1, Robert N Baldassano, MD2, Lee A Denson, MD3,4 and Kevin A Hommel, PhD1,4

1Center for the Promotion of Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 2Center for Pediatric Inflammatory Bowel Disease, Division of Gastroenterology, Hepatology, and Nutrition, Children's Hospital of Philadelphia, Department of Pediatrics, University of Pennsylvania School of , 3Schubert-Martin Inflammatory Bowel Disease Center, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, and 4Department of Pediatrics, University of Cincinnati College of Medicine

All correspondence concerning this article should be addressed to Kevin A. Hommel, PhD, Center for the Promotion of Treatment Adherence and Self-Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Ave., MLC 7039, Cincinnati, OH 45229-3039, USA. E-mail: kevin.hommel{at}cchmc.org


  Abstract

Objective To identify family-reported, adherence-related barriers for adolescents with inflammatory bowel disease (IBD) and examine their relationship to 6-MP/azathioprine and 5-ASA medication adherence. Methods Participants included 74 adolescents, aged 13–17 years, diagnosed with IBD and their caregivers. Adolescents and caregivers jointly completed a measure of barriers to medication adherence. Adherence to medication was measured by family-report, pill-count, and serum assay. Results Families endorsed one to seven total barriers to medication adherence. The most commonly reported barriers included forgetting, being away from home, and interference with an activity. Neither demographic nor disease severity variables were related to the total number of reported barriers. Fewer total reported barriers was related to better adherence by adolescent and maternal report. Conclusion Most families experience at least one barrier to treatment adherence. Effective problem-solving around these barriers and its integration into future treatment protocols may help improve medication adherence in the pediatric IBD population.

Key words: adherence; barriers; Crohn's disease; pediatric; ulcerative colitis..

Received June 15, 2009; revision received July 28, 2009; accepted August 25, 2009


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