Systematic and Meta-Analytic Review: Medication Adherence Among Pediatric Patients With Sickle Cell Disease

J Pediatr Psychol. 2016 May;41(4):406-18. doi: 10.1093/jpepsy/jsv084. Epub 2015 Sep 18.


Objective: To provide a comprehensive summary (systematic review) of medication adherence rates by assessment method and medication type for pediatric patients with sickle cell disease (SCD), as well as identify important correlates for future research.

Methods: Articles assessing medication adherence and published between 1982 and February 2015 (n = 49) were identified using electronic databases. A meta-analysis of 14 studies examining demographic, medical, and psychosocial factors and medication adherence was conducted.

Results: Adherence rates ranged from 12% to 100% across all medications. Approximately 30% of studies reported associations between adherence and key demographic, medical, and psychosocial correlates. Mean effect sizes were small to moderate (r = .02-.53).

Conclusions: The wide range of adherence rates reported in the literature may be because of, in part, the use of variable assessment strategies. Future studies examining pediatric SCD adherence should incorporate key correlates with the goal of replication.

Keywords: adherence; children; meta-analysis; sickle cell disease; systematic review.

Publication types

  • Meta-Analysis
  • Research Support, N.I.H., Extramural
  • Review
  • Systematic Review

MeSH terms

  • Anemia, Sickle Cell / drug therapy*
  • Anemia, Sickle Cell / psychology
  • Child
  • Humans
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data*