title: Adherence in adolescents with Type 1 diabetes: strategies and considerations for assessment in research and practice.
abstract: Suboptimal adherence remains a significant concern for adolescents with Type 1 diabetes, the treatment regimen for which is complex and includes numerous behaviors. Accurate assessment of adherence is critical for effective healthcare and to measure trial outcomes. Without a valid biomarker of adherence, assessment strategies must rely on measuring management behaviors. This paper provides an overview of approaches to measure adherence, with an emphasis on contemporary, validated measures that are appropriate for current diabetes care. Objective measures include electronic data from diabetes management devices. Subjective measures include self/parent-report questionnaires, structured interviews and diaries/logbooks. Practical strategies for selecting measurement approaches for clinical and research purposes are reviewed, and implications of adherence assessment for clinical care delivery and adherence-promotion are discussed.
authors.affiliation: Section of Pediatric Diabetes & Endocrinology, Department of Pediatrics, Baylor College of Medicine, 6701 Fannin Street, Suite 1020, Houston, TX 77030, USA.
authors.forename: Kajal
authors.initials: K
authors.lastname: Gandhi
authors.affiliation: Section of Pediatric Diabetes & Endocrinology, Department of Pediatrics, Baylor College of Medicine, 6701 Fannin Street, Suite 1020, Houston, TX 77030, USA.
authors.forename: Bach-Mai K
authors.initials: BK
authors.lastname: Vu
authors.affiliation: Section of Psychology, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA.
authors.forename: Sahar S
authors.initials: SS
authors.lastname: Eshtehardi
authors.affiliation: Section of Psychology, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA.
authors.forename: Rachel M
authors.initials: RM
authors.lastname: Wasserman
authors.affiliation: Section of Psychology, Department of Pediatrics, Baylor College of Medicine, 1102 Bates Avenue, Suite 940, Houston, TX 77030, USA.
authors.forename: Marisa E
authors.initials: ME
authors.lastname: Hilliard
keywords: Type 1 diabetes; adherence; adolescence; assessment; research methods