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Adherence to Treatment Among Children with Cardiac Disease

Published online by Cambridge University Press:  23 October 2009

Richard F. Ittenbach ,
Amy E. Cassedy ,
Bradley S. Marino ,
Robert L. Spicer  and
Dennis Drotar
Richard F. Ittenbach
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Amy E. Cassedy*
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Bradley S. Marino
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Robert L. Spicer
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
Dennis Drotar
Affiliation:
Cincinnati Children’s Hospital Medical Center, Cincinnati, OH
*
Correspondence to: Amy Cassedy, PhD., Division of Biostatistics and Epidemiology (MLC 5041), 3333 Burnet Avenue, Cincinnati, OH 45229; E-mail: [email protected]
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Abstract

Objective

Our purpose was to review the literature with respect to issues of adherence to treatment among children with congenital and acquired cardiac disease.

Materials and Methods

Databases used for this review included MEDLINE, Pub Med’s Single Citation Manager, Cochrane Library, Cochrane Central Register of Controlled Trials, Scopus, and Google Scholar. We did not use any restrictions on date when locating peer-reviewed articles published worldwide through December of 2008.

Results

There exists a lack of published research regarding adherence to medical treatment for children with cardiac conditions. Of the few published studies, rates of adherence for children with congenital and acquired cardiac disease ranged from a high of 96% for an in-patient exercise programme, to a low of 33% among those who made all of their medical appointments. Risk factors for nonadherence included older age, one as opposed to two parents in the home, lack of emotional availability of parents, smoking, sedentary lifestyle, use of illicit drugs, presence of tattoos, and multiple body piercings. Clinical outcomes associated with non adherence in the population of children undergoing transplantation included mortality, acute episodes of rejection, lower levels of Cyclosporine A, and lower values for the International Normalised Ratio of prothrombin.

Conclusions

For children with congenital and acquired heart disease, the challenges of adherence to treatment can often be overwhelming. Recommendations designed to maximize the impact and scientific rigour of future studies include obtaining quantitative and qualitative measures of adherence, identifying primary and secondary endpoints, emphasizing factors of interest, planning studies with sufficient power to impact on the adherence to treatment, and developing epidemiologic foundations.

Keywords

Therapeuticscongenital heart diseaseadolescents
Type
Review
Information
Cardiology in the Young , Volume 19 , Issue 6 , December 2009 , pp. 545 - 551
Copyright
Copyright © Cambridge University Press 2009

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References

1.Bunchman, TE. Compliance in pediatric transplant. Pediatr Transplant 2000; 4 (3): 165–169.Google Scholar
2.Sherry, DC, Simmons, B, Wung, SF, Zerwic, JJ. Noncompliance in heart transplantation: a role for the advanced practice nurse. Prog Cardiovasc Nurs 2003; 18 (3): 141–146.CrossRefGoogle ScholarPubMed
3.Hsu, DT. Biological and psychological differences in the child and adolescent transplant recipient. Pediatr Transplant 2005; 9 (3): 416–421.CrossRefGoogle ScholarPubMed
4.Roberts, MC. Handbook of Pediatric Psychology. Guilford Publications, Inc., New York, NY, 2003.Google Scholar
5.Kools, S, Kennedy, C, Engler, M, Engler, M. Pediatric hyperlipidemia: child and adolescent disease understandings and perceptions about dietary adherence. J Spec Pediatr Nurs 2008; 13 (3): 168–179.CrossRefGoogle ScholarPubMed
6.Lawrence, K, Stilley, CS, Olshansky, E, Bender, A, Webber, SA. Further exploration: maturity and adherence in adolescent and young adult heart transplant recipients. Prog Transplant 2008; 18 (1): 50–54.CrossRefGoogle ScholarPubMed
7.McAllister, S, Buckner, EB, White-Williams, C. Medication adherence after heart transplantation: adolescents and their issues. Prog Transplant 2006; 16 (4): 317–323.CrossRefGoogle ScholarPubMed
8.DiMatteo, MR. Variations in patients’ adherence to medical recommendations: a quantitative review of 50 years of research. Med Care 2004; 42 (3): 200–209.CrossRefGoogle ScholarPubMed
9.Kahana, S, Drotar, D, Frazier, T. Meta-analysis of psychological interventions to promote adherence to treatment in pediatric chronic health conditions. J Pediatr Psychol 2008; 33 (6): 590–611.CrossRefGoogle ScholarPubMed
10.Chartrand, C, Servando, ES, Chartrand, S. Risk factors for acute rejection after pediatric heart transplantation. Transplant Proc 2001; 33 (1–2): 1732–1734.Google Scholar
11.Christensen, TD, Andersen, NT, Maegaard, M, Hansen, OK, Hjortdal, VE, Hasenkam, JM. Oral anticoagulation therapy in children: successfully controlled by self-management. Heart Surg Forum 2004; 7 (4): E321–E325.CrossRefGoogle ScholarPubMed
12.Christensen, TD, Attermann, J, Hjortdal, VE, Maegaard, M, Hasenkam, JM. Self-management of oral anticoagulation in children with congenital heart disease. Cardiol Young 2001; 11 (3): 269–276.Google Scholar
13.Stilley, CS, Lawrence, K, Bender, A, Olshansky, E, Webber, SA, Dew, MA. Maturity and adherence in adolescent and young adult heart recipients. Pediatr Transplant 2006; 10 (3): 323–330.Google Scholar
14.Wray, J, Waters, S, Radley-Smith, R, Sensky, T. Adherence in adolescents and young adults following heart or heart-lung transplantation. Pediatr Transplant 2006; 10 (6): 694–700.CrossRefGoogle ScholarPubMed
15.McBride, MG, Binder, TJ, Paridon, SM. Safety and feasibility of inpatient exercise training in pediatric heart failure: a preliminary report. J Cardiopulm Rehabil Prev 2007; 27 (4): 219–222.CrossRefGoogle ScholarPubMed
16.Serrano-Ikkos, E, Lask, B, Whitehead, B, Eisler, I. Incomplete adherence after pediatric heart and heart-lung transplantation. J Heart Lung Transplant 1998; 17 (12): 1177–1183.Google ScholarPubMed
17.Ringewald, JM, Gidding, SS, Crawford, SE, Backer, CL, Mavroudis, C, Pahl, E. Nonadherence is associated with late rejection in pediatric heart transplant recipients. J Pediatr 2001; 139 (1): 75–78.CrossRefGoogle ScholarPubMed
18.Drotar, D. Promoting adherence to treatment in childhood chronic illness: Concepts, methods, and interventions. Erlbaum, Mahwah, N.J., 2000.Google Scholar
19.Rapoff, MA. Adherence to pediatric medical regimens. Kluwer Academic/Plenum Publishers, New York, N.Y., 1999.Google Scholar
20.Modi, AC, Lim, CS, Yu, N, Geller, D, Wagner, MH, Quittner, AL. A multi-method assessment of treatment adherence for children with cystic fibrosis. J Cyst Fibros 2006; 5 (3): 177–185.Google Scholar
21.Harris, MA, Wysocki, T, Sadler, M, et al. Validation of a structured interview for the assessment of diabetes self-management. Diabetes Care 2000; 23 (9): 1301–1304.CrossRefGoogle ScholarPubMed
22.Pai, A, Drotar, D. Treatment adherence impact: The systematic assessment and quantification of the impact of treatment adherence on pediatric medical and psychological outcomes. J Pediatr Psychol Submitted 2009.Google ScholarPubMed
23.Fine, RN, Becker, Y, De Geest, S, et al. Nonadherence consensus conference summary report. Am J Transplant 2009; 9 (1): 35–41.CrossRefGoogle ScholarPubMed
24.Moher, D, Schulz, KF, Altman, D. The CONSORT statement: revised recommendations for improving the quality of reports of parallel-group randomized trials. JAMA 2001; 285 (15): 1987–1991.Google Scholar
25.Stinson, JN, McGrath, PJ, Yamada, JT. Clinical trials in the Journal of Pediatric Psychology: applying the CONSORT statement. J Pediatr Psychol 2003; 28 (3): 159–167.Google Scholar
26.Des Jarlais, DC, Lyles, C, Crepaz, N. Improving the reporting quality of nonrandomized evaluations of behavioral and public health interventions: the TREND statement. Am J Public Health 2004; 94 (3): 361–366.CrossRefGoogle Scholar