title: Adherence to Oral Maintenance Treatment in Adolescents With Inflammatory Bowel Disease.
abstract: OBJECTIVE
  The aim of this study was to systematically review the rates of nonadherence to oral maintenance treatment in adolescents with inflammatory bowel disease (IBD), and to describe perceived barriers to adherence and psychosocial factors involved.
  
  
  METHODS
  The article considered studies published in MEDLINE, Embase, and PsycINFO up to March 2015. Studies that had collected data on adherence to thiopurines or aminosalicylates in a cohort of adolescents with IBD. Case reports and case series were excluded.
  
  
  RESULTS
  A total of 25 studies were included. Lack of uniformity of outcome measures made pooling of data impossible. Rates of medication nonadherence ranged from 2% to 93%. The most frequently reported barriers were "just forgot," "wasn't home," and "interferes with activity." Family dysfunction, peer victimization, poor health-related quality of life, poor child-coping strategies, anxiety, and depressive symptoms were associated with medication nonadherence.
  
  
  CONCLUSIONS
  Nonadherence to oral maintenance therapy in adolescents with IBD is a significant health care problem and can lead to unnecessary escalation in therapy. Difficulties in family and social interactions, and psychosocial dysfunction can jeopardize IBD treatment outcome and should receive attention early in the course of the disease.
authors.affiliation: *Department of Pediatrics, Medical Spectrum Twente, Enschede †Department of Pediatric Gastroenterology, Academic Medical Center, Amsterdam ‡Department of Pediatric Gastroenterology, University Medical Center Groningen, Groningen, The Netherlands.
authors.forename: Lieke M
authors.initials: LM
authors.lastname: Spekhorst
authors.forename: Thalia Z
authors.initials: TZ
authors.lastname: Hummel
authors.forename: Marc A
authors.initials: MA
authors.lastname: Benninga
authors.forename: Patrick F
authors.initials: PF
authors.lastname: van Rheenen
authors.forename: Angelika
authors.initials: A
authors.lastname: Kindermann
mesh_terms: D000223:Adaptation, Psychological; D000293:Adolescent; D001007:Anxiety; D003863:Depression; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy / Q000523:psychology*; D055118:Medication Adherence / Q000523:psychology*; D011788:Quality of Life; D013315:Stress, Psychological