Meta-analysis of psychological interventions to promote adherence to treatment in pediatric chronic health conditions

J Pediatr Psychol. 2008 Jul;33(6):590-611. doi: 10.1093/jpepsy/jsm128. Epub 2008 Jan 11.

Abstract

Objective: To estimate the effectiveness of adherence-promoting psychological interventions for pediatric populations with chronic health conditions.

Methods: A meta-analysis was conducted on 70 adherence-promoting psychological intervention studies among chronically ill youth using a weighted least squares approach and random effect model.

Results: Medium effects sizes were found for the behavioral (mean d =.54, 95% confidence interval [CI] = 0.34-0.73, n = 10) and multi-component interventions (mean d =.51, 95% CI = 0.45-0.57, n = 46), while educational interventions displayed a small effect size with adherence (mean d =.16, 95% CI = 0.10-0.22, n = 23). Study designs incorporating pre-post comparisons yielded effect sizes approaching the medium range (mean d =.42, 95% CI = 0.36-0.48, n = 30).

Conclusions: Behavioral and multi-component interventions appear to be relatively potent in promoting adherence among chronically ill youth. Recommendations for future research and methodological issues are presented.

Publication types

  • Meta-Analysis

MeSH terms

  • Behavior Therapy / methods*
  • Child
  • Chronic Disease
  • Health Status*
  • Humans
  • Mental Disorders / epidemiology*
  • Mental Disorders / therapy*
  • Patient Compliance / statistics & numerical data*