title: Opportunities for cystic fibrosis care teams to support treatment adherence.
abstract: BACKGROUND
  The purpose of this study was to identify the extent to which pediatric and adult cystic fibrosis (CF) care teams implement best practices in adherence assessment and counseling.
  
  
  METHODS
  All US CF Foundation accredited programs were invited to participate in a web-based survey; 80% (92/115) of pediatric and 40% (38/95) of adult centers participated. Health care providers reported on current approaches and barriers to implementing adherence promotion practices.
  
  
  RESULTS
  64% discussed adherence at every clinic visit while only 8% used an objective assessment of adherence. Most centers reported frequent use of strategies to increase knowledge; behavioral and support strategies were used less regularly. Several barriers to adherence promotion were reported.
  
  
  CONCLUSIONS
  Many opportunities exist for care teams to improve consistency in adherence practices and integrate a greater repertoire of effective counseling strategies into clinic visits. Adherence promotion practices should be considered for quality improvement (QI) projects.
authors.affiliation: Johns Hopkins Adherence Research Center, The Johns Hopkins University, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. Electronic address: kriekert@jhmi.edu.
authors.forename: Kristin A
authors.initials: KA
authors.lastname: Riekert
authors.affiliation: Johns Hopkins Adherence Research Center, The Johns Hopkins University, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. Electronic address: meakin1@jhmi.edu.
authors.forename: Michelle N
authors.initials: MN
authors.lastname: Eakin
authors.affiliation: Johns Hopkins Adherence Research Center, The Johns Hopkins University, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. Electronic address: abilder1@jhmi.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Bilderback
authors.affiliation: Johns Hopkins Adherence Research Center, The Johns Hopkins University, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA. Electronic address: aridge@jhmi.edu.
authors.forename: Alana K
authors.initials: AK
authors.lastname: Ridge
authors.affiliation: Cystic Fibrosis Foundation, 6931 Arlington Road, Suite 200, Bethesda, MD 20814, USA. Electronic address: bmarshall@cff.org.
authors.forename: Bruce C
authors.initials: BC
authors.lastname: Marshall
mesh_terms: D000328:Adult; D002648:Child; D003376:Counseling; D003550:Cystic Fibrosis / Q000175:diagnosis / Q000523:psychology / Q000628:therapy*; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D009723:Nurse-Patient Relations; D010348:Patient Care Team / Q000458:organization & administration*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010353:Patient Education as Topic / Q000458:organization & administration*; D010817:Physician-Patient Relations; D058996:Quality Improvement; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014481:United States
keywords: Adherence; Barriers; Counseling; Education; Provider