Medication adherence and regimen responsibility (RR) have important implications for adolescents with hemodialysis-dependent end-stage renal disease (ESRD). This case study assesses the preliminary efficacy of a cognitive-behavioral intervention to promote medication adherence and RR in two African American adolescents. Two patients and their mothers participated. Intervention modules addressed adherence barriers. Using a case-series design, weekly parent–adolescent reports of medication adherence and RR were collected. The female participant’s selective nonadherence improved during treatment. Mother and daughter were high in RR throughout the study. The male participant’s adherence initially decreased following his mother’s reduced involvement in treatment. His adherence improved by the end of treatment, and coincided with his mother’s reassumption of RR. Improvements were maintained through follow-up for both patients. This case study provides preliminary support for using a cognitive-behavioral protocol to improve medication adherence in adolescents with hemodialysis-dependent ESRD.
DenhaerynckK.ManhaeveD.DobbelsF.GarzoniD.NolteC.De GeestS. (2007). Prevalence and consequences of nonadherence to hemodialysis regimens. American Journal of Critical Care, 16, 222-235. Available from http://ajcc.aacnjournals.org
3.
DrotarD. (2011). Editorial: Guidance for submitting and reviewing case reports and series in the Journal of Pediatric Psychology. Journal of Pediatric Psychology, 36, 951-958. doi:10.1093/jpepsy/jsr065
4.
FredericksE. M.Dore-StitesD.MageeJ. C.FreedG. L.ShieckV.LopezM. J. (2010). Assessment of transition readiness skills and adherence in pediatric liver transplant recipients. Pediatric Transplantation, 14, 944-953. doi:10.1111/j.13993046.2010.01349.x
5.
FungE.ShawR. J. (2008). Pediatric Transplant Rating Instrument—A scale for the pretransplant psychiatric evaluation of pediatric organ transplant recipients. Pediatric Transplantation, 12, 57-66. doi:10.1111/j.1399-3046.2007.00785.x
6.
GillelandJ.AmaralS.MeeL.BlountR. (2012). Getting ready to leave: Transition readiness in adolescent kidney transplant recipients. Journal of Pediatric Psychology, 37, 85-96. doi:10.1093/jpepsy/jsr049
7.
GravesM. M.AdamsC. D.BenderJ. A.SimonS.PortnoyJ. M. (2007). Volitional nonadherence in pediatric asthma: Parental report of motivating factors. Current Allergy and Asthma Reports, 7, 427-432. doi:10.1007/s11882-007-0065-4
8.
GravesM. M.RobertsM. C.RapoffM.BoyerA. (2010). The efficacy of adherence interventions for chronically ill children: A meta-analytic review. Journal of Pediatric Psychology, 35, 368-382. doi:10.1093/jpepsy/jsp072
9.
GreenleyR. N.DoughtyA.StephensM.KugathasanS. (2010). Brief report: Development of the Inflammatory Bowel Disease Family Responsibility Questionnaire. Journal of Pediatric Psychology, 35, 183-187. doi:10.1093/jpepsy/jsp052
10.
HeafJ. (2004). Underutilization of peritoneal dialysis. Journal of the American Medical Association, 291, 740-742. doi:10.1001/jama.291.6.740
11.
HelgesonV. S.ReynoldsK. A.SiminerioL.EscobarO.BeckerD. (2008). Parent and adolescent distribution of responsibility for diabetes self-care: Links to health outcomes. Journal of Pediatric Psychology, 33, 497-508. doi:10.1093/jpepsy/jsm081
12.
JanzN. K.BeckerM. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11, 1-47. doi:10.1177/109019818401100101
13.
KahanaS.DrotarD.FrazierT. (2008). Meta-analysis of psychological interventions to promote adherence treatment in pediatric chronic health conditions. Journal of Pediatric Psychology, 33, 590-611. doi:10.1093/jpepsy/jsm128
14.
LoganD.ZelikovskyN.LabayL.SpergelJ. (2003). The Illness Management Survey: Identifying adolescents’ perceptions of barriers to adherence. Journal of Pediatric Psychology, 28, 383-392. doi:10.1093/jpepsy/jsg028
15.
MagrabP. R.PapadopoulouZ. L. (1977). The effect of a token economy on dietary compliance for children on hemodialysis. Journal of Applied Behavior Analysis, 10, 573-578. doi:10.1901/jaba.1977.10-573
16.
PaiA. L. H.GrayE.KurivialK.RossJ.SchoborgD.GoebelJ. (2010). The Allocation of Treatment Responsibility scale: A novel tool for assessing patient and caregiver management of pediatric medical treatment regimens. Pediatric Transplantation, 14, 993-999. doi:10.1111/j.1399-3046.2010.01391.x
17.
PaiA. L. H.OstendorfH. M. (2011). Treatment adherence in adolescents and young adults affected by chronic illness during the health care transition from pediatric to adult health care: A literature review. Children’s Health Care, 40, 16-33. doi:10.1080/02739615.2011.537934
18.
RapoffM. A. (2010). Adherence to pediatric medical regimens. New York, NY: Springer.
19.
RianthavornP.EttengerR. B. (2005). Medication nonadherence in the adolescent renal transplant recipient: A clinician’s viewpoint. Pediatric Transplantation, 9, 398-407. doi:10.1111/j.1399-3046.2005.00358.x
20.
SharpJ.WildM. R.GumleyA. I. (2005). A systematic review of psychological interventions for the treatment of nonadherence to fluid-intake restrictions in people receiving hemodialysis. American Journal of Kidney Diseases, 45, 15-27. doi:10.1053/j.ajkd.2004.09.010
21.
SimonsL. E.BlountR. L. (2007). Identifying barriers to medication adherence in adolescent transplant recipients. Journal of Pediatric Psychology, 32, 831-844. doi:10.1093/jpepsy/jsm030
U.S. Renal Data System (USRDS). (2011). Annual Data Report: Atlas of End-Stage Renal Disease in the United States. National Institutes of Health, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD. Retrieved from http://www.usrds.org/atlas.aspx
24.
World Health Organization. (2003). Adherence to long-term therapies: Evidence for action. Geneva, Switzerland: Author.
25.
ZelikovskyN.SchastA. P. (2008). Eliciting accurate reports of adherence in a clinical interview: Development of the Medical Adherence Measure. Pediatric Nursing, 34, 141-146. Retrieved from http://www.pediatricnursing.net/
26.
ZelikovskyN.SchastA. P.PalmerJ. A.MeyersK. E. C. (2008). Perceived barriers to adherence among adolescent renal transplant candidates. Pediatric Transplantation, 12, 300-308. doi:10.1111/j.1399-3046.2007.00886.x
