title: Family strategies for achieving medication adherence in pediatric kidney transplantation.
abstract: BACKGROUND
  Although nonadherence is well documented and strategies for adherence have been shown to be critical to overcoming barriers and improving overall adherence rates, it is unknown how family strategy use is related to adherence in the pediatric renal transplant population.
  
  
  OBJECTIVE
  The aims of this study were to assess (a) the strategies used by adolescents with kidney transplants and their caregivers to adhere to the posttransplant oral medication regimen and (b) the relationship of these strategies to objective adherence rates.
  
  
  METHODS
  Semistructured interviews to assess self-management were administered to 17 adolescents (14-18 years) and 17 caregivers. Adherence to oral immunosuppressant medication, measured via electronic monitors, was determined also for a subset of 13 dyads.
  
  
  RESULTS
  Common strategies endorsed by families included the following: making it part of the routine (88.2%), verbal reminders by caregiver (82.4%), caregiver verifying medication was taken (76.5%), placing medication in a convenient location (76.5%), and using a pillbox (70.6%). A greater number of family-endorsed strategies were correlated with higher levels of adherence. Of those strategies spontaneously endorsed, only caregiver reminders to take medication and caregiver verification that medications were taken were related significantly to higher adherence rates.
  
  
  CONCLUSIONS
  The findings highlight the importance of identification and use of specific strategies to improve adherence rates of pediatric renal transplant recipients and emphasize the need for continued caregiver involvement in the promotion of adherence to the treatment regimen.
authors.affiliation: Center for Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Ingerski
authors.forename: Lauren
authors.initials: L
authors.lastname: Perrazo
authors.forename: Jens
authors.initials: J
authors.lastname: Goebel
authors.forename: Ahna L H
authors.initials: AL
authors.lastname: Pai
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D017028:Caregivers; D005195:Family Relations; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D016030:Kidney Transplantation; D008297:Male; D055118:Medication Adherence; D017010:Reminder Systems; D012646:Self Administration
chemical_list: D007166:Immunosuppressive Agents