Rapoff Adherence to Pediatric Medical Regimens

2. Auflage 2010
ISBN: 978-1-4419-0570-3
Verlag: Springer
Format: PDF
Kopierschutz: 1 - PDF Watermark

E-Book, Englisch, 232 Seiten

Reihe: Issues in Clinical Child Psychology

It used to be called noncompliance, and the patients themselves referred to as difficult. But regardless of the terminology, children's reluctance or failure to commit to prescribed regimens reduces the effectiveness of treatment, often leading to additional care, higher costs, and serious, even deadly, complications. Reflecting a single, authoritative voice, the Second Edition of Adherence to Pediatric Medical Regimens analyzes in comprehensive clinical detail the factors that affect children's and teens' commitment to treatment - from developmental issues to the influence of parents, peers, and others in their orbit - and offers empirically sound guidelines for encouraging adherence. It cautions against viewing young clients as miniature grownups or scaling down adult data, advocating instead for a more nuanced understanding of the population and a collaborative relationship between practitioner and client. Critical areas of interest to clinicians and researchers in pediatrics are brought into clear focus as the book: Provides an overview of adherence rates to chronic and acute disease regimens and examines common adherence problems in children and adolescents. Details consequences of nonadherence and correlates of adherence. Critiques major adherence theories and their clinical implications. Discusses the range of adherence assessment measures. Reviews educational, behavioral and other strategies for improving adherence. Offers ways to translate research into pediatric medical adherence. This updated edition of Adherence to Pediatric Medical Regimens is an essential reference for anyone concerned with improving health outcomes in young people, especially clinicians, researchers, and graduate students in psychiatry as well as pediatric, clinical child, and health psychology.

Michael Rapoff received his PhD in Developmental and Child Psychology in 1980 from the University of Kansas and completed a two year post-doctoral internship in Behavioral Pediatrics at the University of Kansas Medical Center. Dr. Rapoff is currently Ralph L. Smith Professor of Pediatrics and Chief of the Behavioral Pediatrics division in the Department of Pediatrics at the University of Kansas Medical Center. Dr. Rapoff is a Fellow of the American Psychological Association, is a licensed psychologist in Kansas and Missouri, and is listed in the National Registry of Health Service Providers in Psychology. His research interests during the past 26 years has focused on psychosocial issues affecting children and adolescents with chronic diseases, including adherence to medical regimens, pain, and psychosocial adjustment.
He has been funded by NIH and Maternal and Child Health to evaluate strategies for improving adherence to medical regimens for children with asthma and juvenile rheumatoid arthritis (JRA) and by the Arthritis Foundation for evaluating a cognitive-behavioral pain management program for children and adolescents with JRA. Dr. Rapoff has 73 publications in journals or books, including a single-authored book published in 1999 on pediatric medical adherence (Adherence to Pediatric Medical Regimens, Kluwer/Plenum). In 2003, Dr. Rapoff received the Distinguished Scholar Award from the Association of Rheumatology Health Professionals, a division of the American College of Rheumatology, in recognition of outstanding rheumatology scholarship. Also in 2003, Dr. Rapoff was elected as a Fellow in the Society of Pediatric Psychology, Division 54 of the American Psychological Association.
Dr. Rapoff is currently funded by NIH to evaluate the efficacy of a computer-based CD-ROM program (Headstrong) for treating chronic headaches in children. In addition to his research, Dr. Rapoff trains clinical psychology students in health psychology and pediatric psychology and teaches residents and medical students. He also sees patients once per week in his Behavioral Pediatrics Outreach Clinic in Lawrence, KS.

Autoren/Hrsg.

Rapoff, Michael A.

Inhaltsverzeichnis

1;Issues in Clinical Child Psychology;1
2;Preface;5
3;Contents;7
4;1 Definitions of Adherence, Types of Adherence Problems, and Adherence Rates;11
4.1; Definitions;11
4.2; Types of Adherence Problems;13
4.3; Adherence Rates to Acute and Chronic Disease Regimens;14
4.3.1; Adherence to Acute Disease Regimens;14
4.3.2; Adherence to Chronic Disease Regimens;17
5;2 Consequences of Nonadherence and Correlates of Adherence;42
5.1; Consequences of Nonadherence;42
5.1.1; Health and Well-Being Effects;42
5.1.2; Cost-Effectiveness of Medical Care;43
5.1.3; Clinical Decisions;44
5.1.4; Clinical Trials;44
5.2; Correlates of Adherence to Medical Regimens;45
5.2.1; Patient/Family Correlates;46
5.2.2; Disease-Related Correlates;49
5.2.3; Regimen-Related Correlates;50
5.2.4; Correlational Cautions and Risk Profile for Nonadherence;51
5.2.5; Clinical Implications Related to Adherence Correlates;52
6;3 Adherence Theories: Review, Critique,and Clinical Implications;55
6.1; The Health Belief Model;56
6.1.1; Description;56
6.1.2; Critical Appraisal;56
6.1.3; Clinical Implications of the HBM;58
6.2; Social Cognitive Theory (Self-Efficacy);59
6.2.1; Description;59
6.2.2; Critical Appraisal;60
6.2.3; Clinical Implications of SCT (Self-Efficacy);62
6.3; The Theory of Reasoned Action/Planned Behavior;63
6.3.1; Description;63
6.3.2; Critical Appraisal;65
6.3.3; Clinical Implications of the TRA/PB;65
6.4; Transtheoretical Model;66
6.4.1; Description;66
6.4.2; Critical Appraisal;67
6.4.3; Clinical Implications of the TTM;69
6.5; Applied Behavior Analytic Theory;71
6.5.1; Description;71
6.5.2; Critical Appraisal;73
6.5.3; Clinical Implications of ABA Theory;74
6.6; Summary and Implications of Adherence Theories;75
7;4 Measurement Issues: Assessing Adherence and Disease and Health Outcomes;77
7.1; Why Assess Adherence?;77
7.1.1; Screening and Diagnosis;77
7.1.2; Prediction;78
7.1.3; Intervention Selection;78
7.1.4; Evaluation of Intervention Efforts;79
7.2; What Is to Be Assessed? Selection of Target Behaviors;79
7.2.1; Guidelines for Selecting Target Regimen Behaviors;79
7.3; Who Should Be Assessed and Who Should Assess?;81
7.4; How to Assess Adherence? A Critical Review of Assessment Strategies;81
7.4.1; Drug Assays;82
7.4.2; Observation;85
7.4.3; Electronic Monitors;87
7.4.4; Pill Counts;91
7.4.5; Provider Estimates;92
7.4.6; Patient/Parental Reports;94
7.4.7; Comparative Performance of Adherence Measures;102
7.5; Generic Methodological Issues and Recommendations for Adherence Measurement;110
7.5.1; Reactivity;110
7.5.2; Representativeness;110
7.5.3; Directness;111
7.5.4; Measurement Standards;111
7.5.5; Interpretation or What's in a Number?;112
7.5.6; Clinical and Treatment Utility;113
7.6; Assessing Disease and Health Outcomes;114
7.7; Methodological Issues and Recommendations for Disease and Health Measures;116
7.7.1; Choice of Informants;116
7.7.2; Representativeness;116
7.7.3; Generic vs. Disease-Specific Measures;117
7.7.4; Psychometric Standards;118
7.7.5; Limiting ''Physiogenic Bias'';118
7.7.6; Clinical Feasibility, Utility, and Relevance;119
7.8; Conclusions;120
8;5 Strategies for Improving Adherence to Pediatric MedicalRegimens;122
8.1; Educational Strategies for Improving Adherence;123
8.1.1; The ''Why?'' or Goals of Education;123
8.1.2; The ''What?'' or Specific Objectives and Content of Education;123
8.1.3; The ''How?'' of Educational Strategies;124
8.1.4; Summary of Educational Strategies;127
8.2; Organizational Strategies for Improving Adherence;128
8.2.1; Increasing Accessibility to Health Care;128
8.2.2; Consumer-Friendly Clinical Settings;128
8.2.3; Increasing Provider Supervision;129
8.2.4; Simplifying and Minimizing Negative Side Effects of Regimens;130
8.2.5; Summary of Organizational Strategies;132
8.3; Behavioral Strategies for Improving Adherence;134
8.3.1; Parental Monitoring and Supervision;134
8.3.2; Prompting Adherence;136
8.3.3; Adherence Incentives;136
8.3.4; Discipline Strategies;142
8.3.5; Self-Management Strategies;144
8.3.6; Psychotherapeutic Interventions;145
8.3.7; Summary of Behavioral Strategies;147
8.4; Individualizing Interventions: Barriers to Adherence and Functional Analysis;147
8.4.1; Barriers to Adherence;147
8.4.2; Functional Analysis;148
8.5; Technology-Based Interventions;150
8.6; Conclusions;152
9;6 Review of Adherence Intervention Studies and Top Ten Ways to Advance Research on Adherence to Pediatric Medical Regimens;153
9.1; Intervention Studies on Improving Adherence to Regimens for Acute Pediatric Diseases;153
9.2; Intervention Studies on Improving Adherence to Regimens for Chronic Pediatric Diseases;157
9.3; Meta-Analytic Reviews of Adherence Interventions for Pediatric Medical Regimens;158
9.3.1; Meta-Analyses of Adherence Interventions for Adults;158
9.3.2; Meta-Analysis of Adherence Interventions for Acute Pediatric Diseases;183
9.3.3; Meta-Analyses of Adherence Interventions for Chronic Pediatric Diseases;183
9.3.4; Conclusions from the Meta-Analyses;186
9.4; Top Ten Ways to Advance Pediatric Medical Adherence Research (With Apologies to My Colleagues Who Have Heard Me Present This at Two Different National Meetings);187
9.5; The Inflated Importance of Adherence;190
10;References;192
11;Index;218