Staying on the meds: Involving young patients in the treatment for their chronic illnesses

May 8, 2013, University of Nottingham
Staying on the meds: involving young patients in the treatment for their chronic illnesses

Researchers at The University of Nottingham have examined why large numbers of children and young people sometimes don't take their medication, despite suffering from a range of chronic and potentially life-threatening illnesses.

Many children and young people regularly miss doses of medication for a longstanding illness, with adherence rates as low as just 25% among some groups. This can lead to increased rates of and epileptic fits.

The study, which looked at young patients with four , (CHD), diabetes and epilepsies—revealed that , a change of routine and lack of parental involvement were three main reasons why children didn't always take their medicines.

The Talking About Medicines (TABS): Involving Children and Young People with in Managing their Medicines study was led by Professor Rachel Elliott in the University's School of Pharmacy and funded by the National Institute for and Delivery Research (NIHR HS&DR) Programme.

Surprisingly low adherence

Professor Elliott said: "Children with long-term, chronic illnesses often have surprisingly low adherence to medicines that parents or practitioners may, or may not be aware of. Children often have to assume a lot of responsibility for their own health at quite a young age but their voice is not really heard in the consultation, so we don't get to the bottom of their non-adherence.

"This study aimed at revealing the reasons behind that non-adherence to medication and to develop strategies for encouraging young people to continue with their treatment."

From published evidence, more than 40 interviews with parents and children and focus groups with practitioners, the team found that adherence was affected by a number of factors. In addition to tiredness and routine changes, they found doses taken outside the home; a lack of family routine; single parent families; poor parental supervision; a perceived lack of concern from practitioners; and difficulties negotiating the health system all had an impact on whether children took medication regularly.

Parents wanted to maintain control due to a lack of confidence that their child could self-manage their own medication, while children relied on their parents and rituals in the home to remind them to take their medicine, take on board the information given by health professionals in consultations and to liaise with school.

Empowering children

In turn, practitioners admitted they were aware that they often 'talk over' children and young people during consultations and that insufficient time was spent talking about medicines.

The team of researchers worked closely with pharmacists and GPs to develop an intervention involving children, parents and practitioners that aimed to empower children to talk openly and be active partners in decisions about medicine-taking for their illnesses.

The feasibility of the TABS intervention was then tested in 40 child-parent groups, with their practitioners (doctors, nurses and pharmacists).

It showed that, in those that used it, there was a significant improvement in children's psycho-social wellbeing over time, and that they rated themselves as being more in control of their own health.

In total, more than half—ten out of 14—practitioners found the intervention useful although it revealed that encouraging practitioners to address adherence in children and is a challenge due to their workload.

Professor Elliott added: "Our observations showed that consultations with practitioners were often targeted at the parent rather that the child, who is expected to play a responsible role in adhering to their own medication.

"A bigger study is needed to test the effects on medicines adherence and patient outcomes and further work is needed to integrate into children's care pathways."

Explore further: Parental problems prevent children taking much-needed asthma medication

Related Stories

Parental problems prevent children taking much-needed asthma medication

September 4, 2012
Vienna, Austria: Parental problems and a chaotic home environment could be preventing children from taking their prescribed asthma medication.

Alternative medicine doesn't affect asthma care in children

April 10, 2012
(HealthDay) -- Complementary and alternative medicine (CAM) is not associated with adherence to pediatric asthma treatment, according to a study published online April 9 in Pediatrics.

Recommended for you

Number of older people with four or more diseases will double by 2035, say researchers

January 23, 2018
A study published today in Age and Ageing, the scientific journal of the British Geriatrics Society, reports that the number of older people diagnosed with four or more diseases will double between 2015 and 2035. A third ...

Placental accumulation of flame retardant chemical alters serotonin production in rats

January 22, 2018
A North Carolina State University-led research team has shown a connection between exposure to a widely used flame retardant chemical mixture and disruption of normal placental function in rats, leading to altered production ...

Marijuana use does not lower chances of getting pregnant

January 22, 2018
Marijuana use—by either men or women—does not appear to lower a couple's chances of getting pregnant, according to a new study led by Boston University School of Public Health (BUSPH) researchers.

Women run faster after taking newly developed supplement, study finds

January 19, 2018
A new study found that women who took a specially prepared blend of minerals and nutrients for a month saw their 3-mile run times drop by almost a minute.

Americans are getting more sleep

January 19, 2018
Although more than one in three Americans still don't get enough sleep, a new analysis shows first signs of success in the fight for more shut eye. According to data from 181,335 respondents aged 15 and older who participated ...

Wine is good for you—to a point

January 18, 2018
The Mediterranean diet has become synonymous with healthy eating, but there's one thing in it that stands out: It's cool to drink wine.


Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.