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Advanced understanding of modiﬁable predictors of health care use in pediatric chronic illness is critical to reducing health care costs. We examined the relationship between medication non-adherence and health care use in children and adolescents who have a chronic medical condition.
A systematic review of articles by using PubMed, PsycINFO, and CINAHL was conducted. Additional studies were identiﬁed by searching reference sections of relevant manuscripts. Studies that tested the relationship between medication non-adherence and health care use (ie, hospitalizations, emergency department visits, outpatient visits) or cost in children and adolescents (mean age #18 years) who have a chronic medical condition were included. Extraction of articles was completed by using predeﬁned data ﬁelds.
Ten studies met our inclusion criteria. Nine of the 10 studies reviewed (90%) demonstrated a relationship between medication nonadherence and increased health care use. The directionality of this relationship varied depending on the outcome variable of interest.
Medication non-adherence is related to increased health care use in children and adolescents who have a chronic medical condition and should be addressed in clinical care. Future studies should include randomized controlled trials examining the impact of adherence promotion efforts on health care use and costs
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The design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation of the manuscript were supported in part by grant T32HD068223 for Dr. McGrady.
Dr. Hommel is funded in part by R01HD067174. Funded by the National Institutes of Health (NIH).
This article was featured in:
Infectious Diseases in Children
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