title: Medication barriers predict adolescent transplant recipients' adherence and clinical outcomes at 18-month follow-up.
abstract: OBJECTIVE
  To prospectively validate the Parent and Adolescent Medication Barriers Scales (PMBS and AMBS) for assessing perceived barriers to medication adherence in adolescent transplant recipients by examining the relations of perceived barriers to medication adherence and clinical outcomes at 18-month follow-up.
  
  
  METHODS
  Of the 82 adolescent recipients enrolled in the initial cohort, 66 families participated in the follow-up. Relations among barriers, adherence, and clinical outcomes were examined.
  
  
  RESULTS
  Reported barriers demonstrated temporal stability over an extended span of time. Adolescent-perceived barriers of Disease Frustration/Adolescent Issues and parent-perceived barriers of Regimen Adaptation/Cognitive Issues were associated with poorer adherence to medication taking at follow-up. Interestingly, medical complications and mortality were significantly associated with both parent and adolescent-perceived ingestion issues barriers.
  
  
  CONCLUSIONS
  Barriers to adherence are essential to address in an effort to ameliorate adherence difficulties and potentially reduce the incidence of medical complications.
authors.affiliation: Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Children's Hospital Boston, Boston, MA, 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: Katie
authors.initials: K
authors.lastname: Devine
authors.forename: Ronald L
authors.initials: RL
authors.lastname: Blount
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000523:psychology*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D011446:Prospective Studies; D012931:Social Environment; D055815:Young Adult
chemical_list: D007166:Immunosuppressive Agents