title: Determinants of adherence to methylphenidate and the impact of poor adherence on maternal and family measures.
abstract: OBJECTIVE
  The aim of this study was to examine the association between adherence to immediate-release methylphenidate (IR MPH) and maternal psychological distress, parenting style, parent- child relationship, and perceived family support.
  
  
  METHODS
  The sample consisted of 307 children with attention-deficit hyperactivity disorder (ADHD) (271 boys and 36 girls), 6-17 years of age, who had been treated with IR MPH for the past 6 months. The measures included the Chinese Health Questionnaire, Parental Bonding Instrument, Family APGAR, and Home Behaviors of the Social Adjustment Inventory for Children and Adolescents.
  
  
  RESULTS
  Reasons for poor adherence (n = 79; 25.7%) included forgetting medication (72.7%), the medication having no effect (20.0%), and refusing medication (12.7%). Increased age and three-times-daily administration were the major predictors for poor adherence to IR MPH. Poor adherence was associated with increased degree of maternal psychological distress, indifferent parenting, maternal overprotection/control, poor family support, decreased interaction with parents, and increased problems at home.
  
  
  CONCLUSIONS
  Findings indicate that multiple daily dosing of MPH increases the likelihood of poor adherence, particularly in adolescents, and that poor adherence is associated with impaired maternal/family process. Once-daily administration of MPH is necessary to improve adherence and to decrease the possible exacerbation of tense parent-child relationships caused by poor drug adherence.
authors.affiliation: Department of Psychiatry, National Taiwan University, No. 1 Jen-Ai Road Section 1, Taipei, Taiwan 10051. csg@ntu.edu.tw
authors.forename: Susan S F
authors.initials: SS
authors.lastname: Gau
authors.forename: Hsin-Yi
authors.initials: HY
authors.lastname: Shen
authors.forename: Miao-Churn
authors.initials: MC
authors.lastname: Chou
authors.forename: Ching-Shu
authors.initials: CS
authors.lastname: Tang
authors.forename: Yen-Nan
authors.initials: YN
authors.lastname: Chiu
authors.forename: Churn-Shiouh
authors.initials: CS
authors.lastname: Gau
mesh_terms: D000293:Adolescent; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy*; D000697:Central Nervous System Stimulants / Q000008:administration & dosage / Q000627:therapeutic use*; D002648:Child; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008774:Methylphenidate / Q000008:administration & dosage / Q000627:therapeutic use*; D010287:Parent-Child Relations; D010349:Patient Compliance; D013624:Taiwan
chemical_list: D000697:Central Nervous System Stimulants; D008774:Methylphenidate