Medical adherence and childhood chronic illness: family daily management skills and emotional climate as emerging contributors

Curr Opin Pediatr. 2006 Oct;18(5):551-7. doi: 10.1097/01.mop.0000245357.68207.9b.


Purpose of review: To describe recent research that examines family factors that promote or derail adherence to medical regimens for children with chronic health conditions, primarily asthma, diabetes, and cystic fibrosis. From the past 2 years, eight correlational studies were identified which specifically examined the links between family management strategies, family climate and medical adherence.

Recent findings: Findings from the studies suggest that team-based management strategies and cohesive family climate promote adherence to medical treatments over time. Family interactions that are characterized by conflict and disengagement tend to disrupt adherence and inevitably cause a decline in child health. Moreover, these findings seem to be moderated by child age in that poorer adherence often occurs when a child reaches adolescence and is searching for greater autonomy.

Summary: Future research should consider the challenges in measuring medical adherence in the family context as well as incorporating more naturalistic studies of family interactions. Randomized controlled trials using family-based interventions may consider focusing on medical adherence as an important mediator between family process and child health outcomes.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Asthma / therapy*
  • Child
  • Chronic Disease
  • Cystic Fibrosis / therapy*
  • Diabetes Mellitus / therapy*
  • Emotions*
  • Family / psychology*
  • Home Nursing*
  • Humans
  • Patient Compliance*