Overview
The Pai Lab is examining individual and family factors influencing treatment adherence and developing interventions to promote treatment adherence in pediatric solid organ transplant populations.
Promoting Treatment Adherence in Pediatric Transplant
Nonadherence is a critical problem in the pediatric renal transplant population. The rate of nonadherence to posttransplant medical regimens is, on average, estimated to be 50% and the clinical consequences associated with nonadherence are severe including lower long term survival rates and graft loss. Despite the fact that poor adherence has long been recognized and the consequences of nonadherence severe, the etiologic factors that contribute to nonadherence in children with kidney transplants are not well understood. Research with other pediatric populations suggests that family functioning is a critical and modifiable factor in treatment adherence.
Dr. Pai and her lab are working to develop key family process variables that are related to treatment adherence and medical outcomes in the pediatric transplant populations. We are particularly interested in how families allocate treatment responsibilities. Allocation of treatment responsibility is defined as the way in which families distribute the tasks of a medical regimen in order to effectively and successfully complete a prescribed treatment regimen task.
We are currently conducting a study to develop a measure of allocation of treatment responsibility. The study has two phases. In the first phase we are conducting interviews with children with renal transplants and their families to understand how families manage all aspects of their treatment regimen. Information from these interviews will be qualitatively analyzed and the information derived from the interviews will be used to develop a standardized measure of treatment responsibility. The second phase of the study will test the psychometric properties of the Allocation of Treatment Responsibility measure developed in Phase 1.
For children with kidney transplants, understanding how family factors are related to adherence and how these factors can be modified to promote adherence is crucial for maintaining the graft and the overall health of the child. Knowledge about the family variables described above will be used to develop an intervention that will be incorporated with standard clinical care and will include strategies for providers and patients to use to promote adherence among children with kidney transplants.
