title: Self-reported barriers to medication adherence among chronically ill adolescents: a systematic review.
abstract: OBJECTIVE
  To investigate self-reported barriers to medication adherence among chronically ill adolescents, and to investigate whether barriers are unique to specific chronic diseases or more generic across conditions.
  
  
  METHODS
  A systematic search of Web of Science, PubMed, Embase, PsycINFO, and CINAHL from January 2000 to May 2012 was conducted. Articles were included if they examined barriers to medication intake among chronically ill adolescents aged 13-19 years. Articles were excluded if adolescent's views on barriers to adherence were not separated from younger children's or caregiver's views. Data was analyzed using a thematic synthesis approach.
  
  
  RESULTS
  Of 3,655 records 28 articles with both quantitative, qualitative, and q-methodology study designs were included in the review. The synthesis led to the following key themes: Relations, adolescent development, health and illness, forgetfulness, organization, medicine complexity, and financial costs. Most reported barriers to adherence were not unique to specific diseases.
  
  
  CONCLUSIONS
  Some barriers seem to be specific to adolescence; for example, relations to parents and peers and adolescent development. Knowledge and assessment of barriers to medication adherence is important for both policy-makers and clinicians in planning interventions and communicating with adolescents about their treatment.
authors.affiliation: Center of Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Signe
authors.initials: S
authors.lastname: Hanghøj
authors.affiliation: Center of Adolescent Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark. Electronic address: kirsten.boisen@regionh.dk.
authors.forename: Kirsten A
authors.initials: KA
authors.lastname: Boisen
mesh_terms: D000293:Adolescent; D000294:Adolescent Behavior; D002908:Chronic Disease / Q000628:therapy*; D003365:Costs and Cost Analysis; D006801:Humans; D055118:Medication Adherence; D010290:Parents; D057566:Self Report; D055815:Young Adult
keywords: Adherence; Adolescence; Barriers; Chronic illness; Self-reported; Synthesis