Adherence to Pediatric Medical Regimens

1. Front Matter

   Pages I-XV

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2. Medical Nonadherence Prevalence, Consequences, and Correlates

   Pages 1-21

3. Adherence Theories: Review, Critique, and Clinical Implications

   Pages 23-45

4. Assessing Adherence

   Pages 47-75

5. Assessing Disease and Health Status

   Pages 77-101

6. Strategies for Improving Adherence to Pediatric Medical Regimens

   Pages 103-128

7. Review of Adherence Intervention Studies and Recommendations for Research and Clinical Practice

   Pages 129-149

8. Back Matter

   Pages 167-173

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1. It is incumbent on medical providers that they are asking patients to - here to regimens with demonstrated eficacy, Providers need to remind themselves of the Hippocratic oath: "I will follow that system of regimen which, according to my ability and judgment, I consider for the benefit ofmy patients, and abstain from whatever is deleterious and mischievous" (as cited in Cassell, 199 1, p. 145). 2. Providers need to abandon the "blame and shame" approach to dealing with medical adherence problems. It is tempting to blame patients for adherence failures and shame them into changing their behavior. Providers need to share the blame (or better yet omit blame) and look at their own attitudes and behaviors that impact adherence. For example, failing to simplify regimens or minimize negative side effects can adversely impact patient adherence. 3. Patients and their families are no longer (or maybe were never) satisfied with apassive role in their health care. In fact, the tern compliance lost favor in the literature because it implied for some an authoritarian approach to health care that required unquestioned obedience by patients to provider recommendations (DiMatteo & DiNicola, 1982). Comprehensive and effective health care requires a cooperative relationship between providers and patients and their families. It also acknowledges the following realities, particularly for treating persons with chronic illness: "Doctors do not treat chronic illnesses. The chronically ill treat themselves with the help of their physicians; the physician is part of the treatment.

• ETA
• Enhancement
• children
• health
• intervention
• nature
• research

• University of Kansas Medical Center, Kansas City, Kansas

  Michael A. Rapoff

Policies and ethics