Pediatric asthma: a look at adherence from the patient and family perspective.
Although extensive research has been done in an effort to understand and promote adherence in pediatric asthma, little progress has been made in reducing the prevalence of nonadherence. Some researchers argue that a paradigm shift is necessary to advance the adherence field. Despite the recent trend for increasing the role of families in determining treatment plans, a patient-centered approach has been lacking in adherence to a daily regimen. It is clear that, although patients and families show evidence of inadvertent nonadherence (eg, forgetfulness), they also engage in volitional or intentional nonadherence, via reasoned and purposeful decisions. Patients conduct "experiments" with their regimen components in an effort to balance the burden of disease with the burden of treatment. These experiments typically involve some degree of nonadherence. Perhaps, if researchers strive to better understand the decision-making process involved in these experiments, health care providers can guide families in making adherence decisions that would lead to attainment of treatment goals, improvement in quality of life, and realization of positive clinical outcomes.
Developmental and Behavioral Sciences, Children's Mercy Hospital, 2401 Gillham Road, Kansas City, MO 64108, USA. cadams@cmh.edu
Christina D
CD
Adams
Meredith L
ML
Dreyer
Chitra
C
Dinakar
Jay M
JM
Portnoy
D000328:Adult; D001249:Asthma / Q000473:pathology*; D001294:Attitude to Health; D001993:Bronchodilator Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D005192:Family Health; D006801:Humans; D010349:Patient Compliance; D018802:Patient-Centered Care
D001993:Bronchodilator Agents