Evidence-based assessment of adherence to medical treatments in pediatric psychology

J Pediatr Psychol. 2008 Oct;33(9):916-36; discussion 937-8. doi: 10.1093/jpepsy/jsm064. Epub 2007 Sep 10.


Objectives: Adherence to medical regimens for children and adolescents with chronic conditions is generally below 50% and is considered the single, greatest cause of treatment failure. As the prevalence of chronic illnesses in pediatric populations increases and awareness of the negative consequences of poor adherence become clearer, the need for reliable and valid measures of adherence has grown.

Methods: This review evaluated empirical evidence for 18 measures utilizing three assessment methods: (a) self-report or structured interviews, (b) daily diary methods, and (c) electronic monitors.

Results: Ten measures met the "well-established" evidence-based (EBA) criteria.

Conclusions: Several recommendations for improving adherence assessment were made. In particular, consideration should be given to the use of innovative technologies that provide a window into the "real time" behaviors of patients and families. Providing written treatment plans, identifying barriers to good adherence, and examining racial and ethnic differences in attitudes, beliefs and behaviors affecting adherence were strongly recommended.

Publication types

  • Comparative Study
  • Review

MeSH terms

  • Adolescent
  • Blood Chemical Analysis
  • Child
  • Chronic Disease / psychology*
  • Chronic Disease / therapy
  • Drug Monitoring
  • Evidence-Based Medicine*
  • Humans
  • Interview, Psychological
  • Medical Records
  • Monitoring, Ambulatory
  • Patient Compliance / psychology*
  • Psychology, Child*
  • Self Disclosure
  • Surveys and Questionnaires
  • Treatment Failure