A Pilot Study Evaluating the Impact of an Adherence-promoting Intervention Among Nonadherent Youth With Inflammatory Bowel Disease

摘要

Abstract Purpose This study examined the feasibility and impact of a multicomponent adherence intervention among youth with Inflammatory Bowel Disease (IBD) who presented to clinic with poor adherence. Design and Methods Medical providers referred twelve adolescents for the intervention, who participated in 4 weekly visits with a caregiver aimed at improving adherence. Results Intervention session attendance was 100% and the intervention was rated as feasible and acceptable. Mean adherence increased 12% from baseline to post-intervention (p 0.01), and 6% from baseline to 1-month follow-up (p 0.025). A generalized linear model revealed significantly greater adherence from baseline to post-intervention (p 0.001), and from baseline to 1-month follow-up (p 0.01). Logistic Regression revealed a nearly 2:1 odds ratio during post-intervention when compared to the Baseline period (p 0.001). Conclusions Findings suggest that the delivery of a multicompoment adherence intervention to poorly adherent youth with IBD can result in significant improvements in their adherence to oral medication. Practice Implications An intervention individually tailored to each family's unique adherence barriers is a feasible and promising treatment approach for improving medication adherence among nonadherent youth seen in clinical care. Highlights ? The impact of an adherence intervention for poorly adherent youth with IBD was explored. ? Parents and youth perceived reduction in stress/worry about adherence and improvements in adherence. ? Use of an electronic pill box may be helpful for families to use to manage and organize daily medication. ? An individually tailored approach is essential to target the unique adherence needs of patients and families.