title: Trajectories of oral medication adherence in youth with inflammatory bowel disease.
abstract: OBJECTIVE
  To examine longitudinal trajectories of oral thiopurine adherence over a 180-day interval in a sample of youth with inflammatory bowel disease (IBD) and to identify the role of disease activity, length of time since diagnosis, and regimen complexity in predicting adherence trajectory class membership.
  
  
  METHODS
  Participants included 96 adolescents (M age = 14.32 years) with IBD. Oral medication adherence was assessed via MEMS Track Caps (i.e., an electronic monitor that allows for real-time assessment of adherence) for 6 months, after which time devices were collected and data were downloaded. Medical record reviews provided information about participants' disease activity, length of time since diagnosis, and regimen complexity (including both medications and supplements) at the time of study enrollment.
  
  
  RESULTS
  Two distinct adherence trajectory classes emerged: Group 1 represented those with consistently near-perfect adherence, whereas Group 2 represented those with mild nonadherence that increased with time. Complexity of medication regimen emerged as the only predictor of trajectory class, with adolescents whose regimen involved more than 1 daily medication administration time being more likely to be classified in Group 2 (i.e., the consistently near-perfect adherence group) than those whose regimen involved only 1 daily medication administration time.
  
  
  CONCLUSIONS
  Distinct classes of adherence trajectories in pediatric IBD can be identified with longitudinal data collection approaches; however, disease and regimen factors offered limited value in predicting adherence trajectory class. Future research should utilize longitudinal conceptualizations of adherence and examine alternative predictors of declining adherence over time.
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science.
authors.forename: Rachel Neff
authors.initials: RN
authors.lastname: Greenley
authors.affiliation: Department of Psychology, The College of Wooster.
authors.forename: Bryan
authors.initials: B
authors.lastname: Karazsia
authors.affiliation: Division of Developmental and Behavioral Sciences, Children's Mercy Hospitals & Clinics.
authors.forename: Jennifer Verrill
authors.initials: JV
authors.lastname: Schurman
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science.
authors.forename: Amitha Prasad
authors.initials: AP
authors.lastname: Gumidyala
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science.
authors.forename: Eve U
authors.initials: EU
authors.lastname: Nguyen
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science.
authors.forename: Molly Mishler
authors.initials: MM
authors.lastname: Thomason
authors.affiliation: Department of Psychology, Rosalind Franklin University of Medicine and Science.
authors.forename: Jennifer G
authors.initials: JG
authors.lastname: Walter
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin.
authors.forename: Joshua
authors.initials: J
authors.lastname: Noe
authors.affiliation: Department of Pediatrics, Medical College of Wisconsin.
authors.forename: Steven
authors.initials: S
authors.lastname: Werlin
authors.affiliation: Department of Pediatrics, Section of Pediatric Gastroenterology, Hepatology, & Nutrition, The University of Chicago Medicine.
authors.forename: Stacy A
authors.initials: SA
authors.lastname: Kahn
mesh_terms: D000293:Adolescent; D002648:Child; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy*; D008297:Male; D055118:Medication Adherence