Getting Kids to Stick with Treatment: New Center Formed to Improve Compliance
Research shows that 17 to 25 percent of children and adolescents in the United States have chronic conditions requiring extended treatment periods. For these patients, adhering to treatment and managing their condition are vital components to their long-term health. According to Cincinnati Children’s psychologist Dennis Drotar, PhD, as many as 50 percent or more of these young patients do not follow prescribed treatment plans, leading to worse health outcomes and higher health care costs.
Dr. Drotar, a nationally recognized leader in behavioral pediatrics, recently joined Cincinnati Children’s in the Division of Behavioral Medicine and Clinical Psychology, to tackle this problem.
Dr. Drotar is director of the newly-formed Center for Treatment Adherence Promotion and Self-Management at Cincinnati Children’s.
“The impact of non-adherence is significant and multi-dimensional,” explains Dr. Drotar. “It limits treatment effectiveness and can contribute to increased morbidity, therapeutic errors and health care costs. It can also be detrimental to the scientific study of medical care by reducing the fidelity and effectiveness of testing new treatments.”
The mission of the center, the first of its kind in the United States, is to provide the research that will shed light on the many social, environmental and behavioral factors that contribute to non-compliance. The next step is to develop models of training and interventions based on this research.
“We are working to establish measurement methodologies through our research,” Dr. Drotar says. “We can then develop specialized clinical services based on these measurements that will lead to increased adherence.”
Getting children with diabetes to comply with their treatment over the long-term is just one of the center’s goals.
Diabetes a Priority
In one of many funded studies being conducted at the center, researchers are working to understand a significant drop-off in treatment compliance that occurs as children with type 1 diabetes enter adolescence.
This NIH-funded, prospective, multi-site study is following a group of children between the ages of 9 and 11 who have type 1 diabetes. The children are being evaluated on factors such as how their parents help manage the health condition and how the child responds. The patients are being followed for three years.
Says Dr. Drotar, “We will be identifying factors that lead to successful adherence versus non-adherence and how to target interventions to promote adherence based on those factors.”
The center has brought on board five nationally-recruited faculty scientists, four of whom are focused on compliance research with chronic conditions, while the fifth specializes in biostatistics and measurement.
“This is an exciting environment to be part of,” says Dr. Drotar. “The level of enthusiasm of our researchers and the depth of talent is exciting and a big part of why I came to Cincinnati Children’s.”
