Helping Teenagers Stick to Treatment Plans
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 their treatment plan and managing their condition are vital to their long-term health. According to Cincinnati Children's Hospital Medical Center psychologist Dennis Drotar, PhD, as many as 50 percent or more of these patients do not follow prescribed treatment plans, leading to worse health outcomes and higher health care costs.
That's why Cincinnati Children's created the Center for Treatment Adherence Promotion and Self-Management, the first of its kind in the United States.
Dr. Drotar, who will direct the center, says its mission is to provide the research that will shed light on the many social, environmental and behavioral factors that contribute to non-adherence.
"The impact of non-adherence is significant and multidimensional," explains Dr. Drotar. "Non-adherence 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."
Dr. Drotar's next step is to develop models of training and interventions based on this research. "We are working to establish measurement methodologies through our research," he says. "We can then help develop specialized clinical services based on these measurement methodologies that will lead to increased adherence."
In one of many 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 years who have Type 1 diabetes. The children are being evaluated on such factors as how parents of these children help manage their child's condition and how the child responds. The patients are being followed for three years.
"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," says Dr. Drotar.
