Overview
The Drotar Lab is working primarily on two projects, treatment adherence in adolescent Leukemia and illness management in children and young adolescents with Type I diabetes.
Promoting Treatment Adherence in Adolescent Leukemia
Scientific evidence suggests that many adolescents with acute lymphoblastic leukemia (ALL) do not take their medication in accord with their prescribed treatment regimens. Such nonadherence may have undesirable clinical and scientific consequences such as:(1) mortality and morbidity due to relapse; and (2) problems in the validity of data concerning clinical trials of medication treatment. However, there are little scientific data concerning the efficacy of psychological interventions that have been designed to limit the prevalence and impact of nonadherence to ALL treatment. To address this important scientific need, this study will conduct a randomized clinical trial (RCT) with adolescents diagnosed with ALL to evaluate a family centered, problem-solving intervention (FPST) to promote adherence to oral medication treatment. This problem solving intervention will be compared with Current psychological care.
The proposed intervention model is novel in its integration of three key components derived from theory and research on adherence to treatment with pediatric illnesses. These are: 1) training in collaborative problem solving and effective parent-adolescent communication to reduce barriers that interfere with adherence to oral medication treatment; 2) promotion of the adolescent's active participation in and motivation for the management of ALL therapy; 3) emphasis on parental support and adolescent adherence to treatment that is consistent with the developmental needs of the adolescent.
We anticipate that the proposed study will identify effective strategies to promote adherence among adolescents with ALL that may potentially lead to improved medical outcomes for these adolescents.
We are currently in the process of study development. We anticipate beginning data collection in early 2008.
Illness Management in Children and Young Adolescents with Type 1 Diabetes
This study will analyze patterns of self-management and adherence to type 1 diabetes (DM1) during early adolescence and identify salient predictors of self-management and treatment adherence. The design is a multisite, prospective study of young adolescents with DM1 assessed over a three-year follow-up period. Cincinnati Children's Hospital Medical Center (CCHMC) will be the central coordinating site for this three site study. University of Miami, FL, and Nemours Clinic, Wilmington, DE are the other two sites. This study will accomplish the following specific aims:
- Describe individual differences and group trends in patterns of change in self-management and treatment adherence for DM1 from early to middle adolescence;
- Identify family and individual influences on self-management and treatment adherence;
- Assess consequences of patterns of self-management and adherence to treatment on blood sugar control, hypoglycemic episodes and health care utilization.
The proposed study will generate scientific data concerning causes and consequences of self-management of DM1 during the critical developmental period of early adolescence. Such information could facilitate development of interventions that target problematic patterns of diabetes self-management among young adolescents in order to lessen potential deterioration in their self-management and treatment adherence and ultimately improve metabolic control.
We are currently collecting data at all three sites. Recruitment will continue at all three sites for at least the next year and a half.
