Adherence to immunosuppressants: how can it be improved in adolescent organ transplant recipients?
OBJECTIVE
Nonadherence among pediatric transplant recipients is prevalent, with rates as high as 75% among adolescents. These rates are alarming given that adherence behavior has the potential to be modified. This review examines evidence from recent studies and position statements to determine the current issues related to improving medication adherence in adolescent transplant recipients.


RESULTS
To date, there are no empirically validated treatments to promote adherence in pediatric transplant recipients. Yet, interventions in other chronic illness populations suggest that combined education and behavioral strategies are the most effective in improving medication adherence. The use of technology, such as the Internet and cellphones, provides a promising mechanism for delivering adherence-promoting interventions to adolescents. Preliminary studies in pediatric solid organ transplant suggest that interventions focused on targeted education and behavioral cues using cellphone text messages are promising strategies for promoting medication adherence.


CONCLUSIONS
Strategies for promoting adherence in adolescent transplant recipients should include developmentally appropriate models and should incorporate health-related education, motivational strategies, and behavioral skills. Interventions should be tailored to meet individual needs, and should be a collaborative effort between the adolescent, family and healthcare providers.
Fredericks
Emily M
EM
Department of Pediatrics, University of Michigan Health System, Ann Arbor, Michigan 48109-5318, USA. emfred@med.umich.edu
Dore-Stites
Dawn
D
D000293:Adolescent; D000294:Adolescent Behavior; D001291:Attitude of Health Personnel; D040421:Cell Phone; D003463:Cues; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D055118:Medication Adherence; D009042:Motivation; D016377:Organ Transplantation; D010287:Parent-Child Relations; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D017010:Reminder Systems; D012307:Risk Factors; D012648:Self Care
D007166:Immunosuppressive Agents