Statement of Need and Purpose
The need for the development of The Center for Adherence Promotion and Self-Management stems from the high prevalence of problems of adherence to medical treatment and the impact on clinical care and research. It is estimated that large numbers of children and adolescents have chronic physical conditions (20% to 25%) or behavioral problems (17% to 22%) that require treatments to be conducted over a long period of time. Data also indicate that adherence to treatment for chronic conditions are very difficult to achieve: The average prevalence of nonadherence is 50% across a range of chronic conditions. Moreover, the impact of treatment nonadherence is significant and multidimensional: With respect to clinical care, nonadherence limits treatment effectiveness and can contribute to increased morbidity and costs of care, therapeutic errors, and disrupt the alliance between professional caregivers and families. Nonadherence to medical treatment can also affect the scientific study of medical care and treatment by limiting treatment fidelity and reducing the effects of scientific tests of new medical and behavior treatments.
Scientists and the National Institute of Health (NIH) have recognized the gap in the science and clinical care related to treatment adherence in critical areas (e.g., description and measurement of adherence and interventions to promote adherence). Treatment adherence is recognized as a priority area in grant portfolios and long range priorities across NIH. In the context of clinical care, new models of clinical management need to be developed to help families manage the demands of medical treatment, promote adherence to treatment, prevent nonadherence, and limit the negative consequences of nonadherence on the health outcomes. Finally, the training of health care professionals would be enhanced by including new methods of adherence promotion and research.
The Center for Treatment Adherence was developed to address the need for state of the art science, clinical care and training that focuses on adherence promotion. Center research, clinical care, and training programs will address areas of national significance and contribute to the mission of Cincinnati Children's Hospital Medical Center by facilitating intradisciplinary collaboration and quality improvement.
