title: Preliminary quantitative investigation of predictors of treatment non-adherence in pediatric transplantation: a brief report.
abstract: The examination of predictors of non-adherence in transplantation populations offers the potential to identify high-risk individuals and concomitantly generate effective adherence-promoting interventions. The present paper aggregated quantitative estimates of various correlates of treatment adherence in studies of pediatric transplantation. Seventeen studies and three classes of predictors of non-adherence, including demographic, psychosocial, and treatment-related predictors, were included in the current analyses. The weighted means effect sizes for the demographic factors were in the small to medium range (female gender mean d = 0.35, 95% CI = 0.32-0.38, n = 8; mean age d = 0.55, 95% CI = 0.52-0.58, n = 7), suggesting that older youth and males tended to display more non-adherence behaviors than younger youth and females, respectively. Several psychosocial factors exhibited large to very large relationships with non-adherence, in particular comorbid psychiatric conditions (mean d = 1.04, 95% CI = 0.66-1.42, n = 3) and child self-responsibility for medication (mean d = 0.88, 95% CI = 0.53-1.23, n = 3). Finally, prior treatment/grafts (mean d = 0.17, 95% CI = -0.15-0.49, n = 3) and donor source (mean d = 0.33, 95% CI = -0.10-0.76, n = 4) exhibited small, non-significant relationships with non-adherence. Limitations of the study are discussed as are future directions for research.
authors.affiliation: Center for the Promotion of Adherence and Self Management, Division of Behavioral Medicine and Clinical Psychology, Cincinnati Childrens Hospital Medical Center, OH, USA. sykahana@gmail.com
authors.forename: Shoshana Y
authors.initials: SY
authors.lastname: Kahana
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Frazier
authors.forename: Dennis
authors.initials: D
authors.lastname: Drotar
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D015233:Models, Statistical; D016377:Organ Transplantation / Q000379:methods; D010349:Patient Compliance / Q000523:psychology*; D010372:Pediatrics / Q000379:methods*; D012306:Risk; D012648:Self Care; D016896:Treatment Outcome