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2. Practice survey: adherence monitoring and intervention in pediatric gastroenterology and hepatology

Author

Maddux,Michele H, Ricks,Shawna, Bass,Julie A, Daniel,James F, Carpenter,Ellen, Radford,Kimberely, Maddux,Michele H, Ricks,Shawna, Bass,Julie A, Daniel,James F, Carpenter,Ellen, and Radford,Kimberely

Abstract

Michele H Maddux,1,2 Shawna Ricks,2 Julie A Bass,2 James F Daniel,2 Ellen Carpenter,2 Kimberely Radford2 1Division of Developmental and Behavioral Sciences, Children’s Mercy-Kansas City, Kansas City, MO, USA; 2Division of Gastroenterology, Children’s Mercy-Kansas City, Kansas City, MO, USA Purpose: Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.Participants and methods: One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.Results: Practices varied greatly in terms of when and how patient adherence is monitored and by whom; however, physicians and nursing professionals take primary responsibility for adherence monitoring. Approximately 25% utilize screeners to assess adherence, and most participants use patient and caregiver reports as a primary measure of adherence. Most participants rated their level of adherence monitoring and intervention as fair to poor. While most participants perceive adherence monitoring to be very important in clinical practice, only 20.8% perceive being able to significantly modify patient adherence.Conclusion: There exists great variability in adherence monitoring and intervention practices across pediatric GI providers. Greater understanding of current adherence practices can inform future clinical efforts. Keywords: adherence, screening, clinical practice, intervention, compliance

Published
2018

6. Patient and Caregiver Perspectives on Transition and Transfer.

Author

Maddux, Michele Herzer, Ricks, Shawna, and Bass, Julie

Subjects
*ANXIETY, *CAREGIVERS, *INFLAMMATORY bowel diseases, *MEDICAL care, *MEDICAL needs assessment, *SCALE analysis (Psychology), *HEALTH self-care, *PATIENTS' attitudes
Abstract

Little is known about the needs of adolescents with inflammatory bowel disease (IBD) with regard to transition, and how well those needs align with guidelines put forth by the American Academy of Pediatrics (AAP). This study examines perspectives on transition among young IBD patients and their caregivers. Surveys were mailed to 370 adolescent IBD patients, aged 12 years and older, and their caregivers. Most respondents endorsed ages 16 to 17 years as the best age to initiate discussions about transition, and age 18 years or older as the best age to transfer care. Independent self-management by patients was selected as the primary marker of transition readiness, while worry of starting over with a new provider was a primary barrier to successful transfer. Overall, the needs of youth with IBD and their caregivers are largely aligned with AAP best practice recommendations for transition. Further examination into patient needs is essential to inform transition planning efforts and identify targets of intervention. [ABSTRACT FROM AUTHOR]

Published
2017
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