Empirically supported treatments in pediatric psychology: regimen adherence.
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.
Lemanek
K L
KL
Ohio State University College of Medicine, USA. lemanekk@chi.osu.edu
Kamps
J
J
Chung
N B
NB
D000293:Adolescent; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D001249:Asthma / Q000188:drug therapy*; D001521:Behavior Therapy / Q000592:standards; D002648:Child; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy / Q000592:standards; D003216:Conditioning, Operant; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy*; D019348:Empiricism; D006801:Humans; D010353:Patient Education as Topic / Q000592:standards; D002666:Psychology, Child / Q000379:methods / Q000592:standards*; D012107:Research Design; D016896:Treatment Outcome; D016312:Treatment Refusal / Q000523:psychology* / Q000706:statistics & numerical data