title: Self-reported adherence to medications in a pediatric renal clinic: psychological aspects.
abstract: BACKGROUND
  Chronically ill children and adolescents comprise a vulnerable population that requires specific considerations in order to positively impact their treatment outcome. Pediatric renal patients can be non-compliant and also forgetful in taking their medications.
  
  
  OBJECTIVE
  The objectives of the study were to (a) assess medication adherence and (b) to identify emotionality and variables that influence non-adherence by use of "The Child & Adolescent Adherence to Medication Questionnaire" (CAAMQ), which was constructed at Texas Tech University Health Sciences Center.
  
  
  METHODS
  Pediatric renal patients from 10 to 21 years-of-age, taking three or more medications, for longer than a three-month period, were eligible to complete the CAAMQ.
  
  
  RESULTS
  Thirty-four patients participated in the study. Many of the respondents had problems remembering to take their medications on weekends (P = 0.021). The majority of the patients stated that they were not bothered about having to take their medications (70.6%); and that taking pills did not interfere with their daily activities (85.3%). Open-ended questions in the CAAMQ identified patients' feelings of sadness, distress, and the importance of strong family support systems. The study participants reported that they preferred to take their medications at school, in the nurses' office or in a place where privacy was assured. The results indicated that Prednisone was the most disliked of all of the medications. Female patients were more reactive and secretive than males regarding peers knowing about their disease and medication schedules (P<0.017).
  
  
  CONCLUSIONS
  Non-adherence in pediatric patients is a complex and serious problem, which ultimately affects the patients' health. Privacy and daily routine were found to impact the patients' adherence to medications. Creative and individualized reminders for teenagers need to be developed and validated. Further studies that take into consideration developmental and motivational factors may help researchers identify modifiable psychosocial predictors that will lead to improved medication adherence.
authors.affiliation: Department of Pediatrics, Texas Tech University Health Sciences Center at Amarillo, Amarillo, Texas, USA. tetyana.vasylyeva@ttuhsc.edu
authors.forename: Tetyana L
authors.initials: TL
authors.lastname: Vasylyeva
authors.forename: Ruchi
authors.initials: R
authors.lastname: Singh
authors.forename: Christopher
authors.initials: C
authors.lastname: Sheehan
authors.forename: Sudha P
authors.initials: SP
authors.lastname: Chennasamudram
authors.forename: Anne P
authors.initials: AP
authors.lastname: Hernandez
mesh_terms: D000293:Adolescent; D004644:Emotions; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000188:drug therapy / Q000523:psychology*; D008297:Male; D010349:Patient Compliance / Q000523:psychology*; D011241:Prednisone; D012737:Sex Factors; D012944:Social Support; D011795:Surveys and Questionnaires; D013781:Texas
chemical_list: D011241:Prednisone