Improving adherence in paediatric respiratory disease

Educational aims To review the evidence on determinants of adherence in children with chronic respiratory disease. To discuss the “common sense model” as a method to understand medication-taking behaviour in children. To review the importance of illness perceptions and medication beliefs in determining adherence to maintenance medication in children with chronic respiratory disease. To present recommendations to optimise adherence through enhancing involvement of patients and parents in consultations of children with chronic respiratory disease. Summary In children with chronic respiratory disease, nonadherence to maintenance medication is common. Observational studies, however, show that good adherence can be achieved and maintained. This review will discuss the current state of the evidence on adherence and its determinants in children with chronic respiratory disease. It will highlight the importance of illness perceptions and medication beliefs as strong drivers of adherence, based on the common sense model of how people deal with a chronic illness. Exploring such cognitions by interested enquiry of the patient9s perspective will help the clinician to identify and overcome barriers to adherence. When decisions on treatment are made according to the principle of shared decision making, concordance between patient and healthcare provider is aided, which improves adherence.