title: Parent and patient perspectives on barriers to medication adherence in adolescent transplant recipients.
abstract: The aim of this study was to identify barriers to medication adherence in adolescent transplant recipients. Eighty adolescent transplant recipient families reported in an open-ended manner about barriers to medication adherence. These responses were then coded to reflect potentially important themes associated with medication adherence. The themes derived included: forgot/distracted, poor planning/scheduling issues, physical barriers/medication issues, and voluntary resistance/attempts to be normal. Inter-rater reliability for barrier coding was very high (k = 0.91). Patients who were classified as non-adherent reported significantly more overall barriers, more forgot/distracted barriers, and more voluntary resistance/attempts to be normal barriers than those classified as adherent. Non-adherence was also found to be more likely when adolescents, as opposed to parents, were responsible for administering the medication. Further, non-adherence was more likely when taking morning rather than evening doses. These findings are explained with an emphasis on potential remedies that directly address the stated barriers.
authors.affiliation: Department of Psychiatry, Children's Hospital Boston & Harvard Medical School, Boston, MA 02115, USA. Laura.Simons@childrens.harvard.edu
authors.forename: Laura E
authors.initials: LE
authors.lastname: Simons
authors.forename: Megan L
authors.initials: ML
authors.lastname: McCormick
authors.forename: Laura L
authors.initials: LL
authors.lastname: Mee
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Blount
mesh_terms: D000293:Adolescent; D001294:Attitude to Health; D002648:Child; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D016377:Organ Transplantation / Q000523:psychology*; D010290:Parents / Q000523:psychology*; D010342:Patient Acceptance of Health Care; D055815:Young Adult