title: Telehealth behavioral treatment for medication nonadherence: a pilot and feasibility study.
abstract: OBJECTIVE
  To evaluate an individually tailored multicomponent nonadherence treatment protocol using a telehealth delivery approach in adolescents with inflammatory bowel disease.
  
  
  METHODS
  Nine participants, age 13.71±1.35 years, completed a brief treatment online through Skype. Medication nonadherence, severity of disease, and feasibility/acceptability data were obtained.
  
  
  RESULTS
  Adherence increased markedly from 62% at baseline to 91% for mesalamine (δ=0.63), but decreased slightly from 61% at baseline to 53% for 6-mercaptopurine /azathioprine. The telehealth delivery approach resulted in cost savings of $100 in mileage and 4 h of travel time/patient. Treatment session attendance was 100%, and the intervention was rated as acceptable, particularly in terms of treatment convenience.
  
  
  CONCLUSIONS
  Individually tailored treatment of nonadherence through telehealth delivery is feasible and acceptable. This treatment shows promise for clinical efficacy to improve medication adherence and reduce costs. Large-scale testing is necessary to determine the impact of this intervention on adherence and health outcomes.
authors: Division of Behavioral Medicine and Clinical Psychology, Center for the Promotion of Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, MLC 7039, Cincinnati, OH 45229-3039, USA. kevin.hommel@cchmc.org
authors: Kevin A
authors: KA
authors: Hommel
authors: Elizabeth
authors: E
authors: Hente
authors: Michele
authors: M
authors: Herzer
authors: Lisa M
authors: LM
authors: Ingerski
authors: Lee A
authors: LA
authors: Denson
mesh_terms: D000293:Adolescent; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001379:Azathioprine / Q000627:therapeutic use; D001521:Behavior Therapy / Q000191:economics / Q000379:methods*; D002648:Child; D017281:Cost of Illness; D003695:Delivery of Health Care / Q000191:economics / Q000379:methods; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence / Q000523:psychology*; D015122:Mercaptopurine / Q000627:therapeutic use; D019804:Mesalamine / Q000627:therapeutic use; D009820:Ohio; D010865:Pilot Projects; D012720:Severity of Illness Index; D017216:Telemedicine / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D007166:Immunosuppressive Agents; D019804:Mesalamine; D015122:Mercaptopurine; D001379:Azathioprine