title: A theoretical approach to medication adherence for children and youth with psychiatric disorders.
abstract: This article provides a theoretical review of treatment adherence for children and youth with psychiatric disorders where pharmacological agents are first-line interventions. Four empirically based models of health behavior are reviewed and applied to the sparse literature about medication adherence for children with attention-deficit/hyperactivity disorder and young people with first-episode psychosis. Three qualitative studies of medication use are summarized, and details from the first-person narratives are used to illustrate the theoretical models. These studies indicate, when taken together, that the clinical approach to addressing poor medication adherence in children and youth with psychiatric disorders should be guided by more than one theoretical model. Mental health experts should clarify beliefs, address misconceptions, and support exploration of alternative treatment options unless contraindicated. Recognizing the larger context of the family, allowing time for parents and children to change their attitudes, and offering opportunities for easy access to medication in the future are important ways of respecting patient preferences, while steering them toward best-evidence interventions. Future research using qualitative methods of inquiry to investigate parent, child, and youth experiences of mental health interventions should identify effective ways to improve treatment adherence.
authors.affiliation: Department of Psychiatry, University of Toronto, Toronto, Canada. alice.charach@sickkids.ca
authors.forename: Alice
authors.initials: A
authors.lastname: Charach
authors.forename: Tiziana
authors.initials: T
authors.lastname: Volpe
authors.forename: Katherine M
authors.initials: KM
authors.lastname: Boydell
authors.forename: Robin E
authors.initials: RE
authors.lastname: Gearing
mesh_terms: D000293:Adolescent; D000328:Adult; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000523:psychology; D001521:Behavior Therapy / Q000379:methods; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003469:Culture; D005260:Female; D017144:Focus Groups; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D033182:Intention; D008297:Male; D001523:Mental Disorders / Q000188:drug therapy* / Q000523:psychology; D008962:Models, Theoretical; D009042:Motivation; D010290:Parents / Q000523:psychology; D010349:Patient Compliance / Q000523:psychology*; D011618:Psychotic Disorders / Q000188:drug therapy / Q000523:psychology; D011619:Psychotropic Drugs / Q000009:adverse effects / Q000627:therapeutic use*; D016312:Treatment Refusal / Q000523:psychology
chemical_list: D014150:Antipsychotic Agents; D000697:Central Nervous System Stimulants; D011619:Psychotropic Drugs