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This article presents the case study of Charlie, a person who suffers from factitious disorder (FD) imposed on self (previously called Munchausen syndrome), a serious psychiatric condition. As described in the Diagnostic and Statistical Manu-al of Mental Diseases (DSM-5), individuals with this disorder intentionally fabricate physical or psychological symptoms for medical attention with no obvious gain. It is extremely difficult to care and accompany patients with factitious disorder. As Wong and Detweiler mention, "Many clinicians remember their first Munchausen syndrome case as if they were seeing medicine through a distorted prism and struggle with residual conflicting thoughts, as the clinical and ethical implications can be challenging."3 Clinicians may unknowingly do harm by prescribing unnecessary tests, medications, and procedures (e.g., narcotics, surgeries) with the associated risks and iatrogenic consequences of being in a hospital for so long. Once it is known that the patient suffers from FD, reactions are ambivalent even perhaps negative, as Denis and Denis outline.4 Some may be reticent to admit that the patient is lying or cheating, some may avoid the issue altogether or just prefer to err on the side of prudent belief and treat accordingly. How then should we respond to Charlie's manifestations of suffering? [ABSTRACT FROM AUTHOR]

Medication non‐adherence is an important factor limiting allograft survival after kidney transplantation in AYA. Some interventions, including the TAKE‐IT, showed some success in promoting adherence but the potential for scalability and use in routine clinical practice is limited. We applied user‐centered design to gather the perspectives of recipients, parents, and health professionals concerning their needs, challenges, and potential intervention strategies to design an optimal, multi‐component medication adherence intervention. The qualitative study was conducted at four Canadian and three American kidney transplant programs. Separate focus groups for recipients, parents, and health professionals were convened to explore these stakeholders' perspectives. Directed content analysis was employed to identify themes that were shared vs distinct across stakeholders. All stakeholder groups reported challenges related to taking medications on time in the midst of their busy schedules and the demands of transitioning toward independence during adolescence. The stakeholders also made suggestions for the multi‐component behavioral intervention, including an expanded electronic pillbox and companion website, education materials, and customized digitized features to support shared responsibility and communication among recipients, parents, and health professionals. Several suggestions regarding the functionality and features of the potential intervention reported in this early stage will be explored in more depth as the iterative process unfolds. Our approach to actively involve all stakeholders in the process increases the likelihood of designing an adherence intervention that is truly user‐informed and fit for the clinical setting. [ABSTRACT FROM AUTHOR]