title: Volitional and accidental nonadherence to pediatric inflammatory bowel disease treatment plans: initial investigation of associations with quality of life and disease activity.
abstract: OBJECTIVE
  To examine rates of volitional and accidental nonadherence, and explore potential differential associations of each with disease activity and quality of life (QOL), in pediatric patients with inflammatory bowel disease (IBD).
  
  
  METHODS
  One hundred families (100 parents, 78 adolescents) recruited from a large Midwestern children's hospital reported on the child's medication nonadherence and QOL. Healthcare providers supplied disease activity ratings.
  
  
  RESULTS
  Most adolescents (73.1%) and parents (70.1%) reported engaging in accidental nonadherence, whereas a smaller group (35 and 30%, respectively) reported engaging in volitional nonadherence to the child's prescribed medication regimen. Frequency of accidental nonadherence was unrelated to disease activity or any specific QOL area examined, whereas greater frequency of volitional nonadherence was associated with greater disease activity and poorer parent reported psychosocial QOL.
  
  
  CONCLUSIONS
  Nonadherence and the relationship with disease severity and QOL may be more complex for children with IBD than understood through previous work.
authors.affiliation: Section of Developmental and Behavioral Sciences, Children’s Mercy Hospitals & Clinics, Kansas City, MO 64108, USA. jschurman@cmh.edu
authors.forename: Jennifer V
authors.initials: JV
authors.lastname: Schurman
authors.forename: Christopher C
authors.initials: CC
authors.lastname: Cushing
authors.forename: Ellen
authors.initials: E
authors.lastname: Carpenter
authors.forename: Kathy
authors.initials: K
authors.lastname: Christenson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000523:psychology / Q000628:therapy*; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires