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Medicines update
What factors affect adherence to medicines?
  1. Laura A Dawson
  1. Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby, UK
  1. Correspondence to Laura A Dawson, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham, Derby DE22 3DT, UK; 09dawsonlaura{at}gmail.com

https://doi.org/10.1136/archdischild-2017-312820

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    Key message

    This review summarises factors which may affect children and young people’s adherence to medicines and aims to give ideas of possible target areas to address in patients where poor adherence is a problem.

    Concern about adherence to prescribed medicines, especially long-term ones, has been apparent since the 1970s.1 A number of terms describing how well patients take their medicines have been used over these years including compliance, perseverance and concordance. Adherence now seems to be preferred as it is considered more factual rather than blaming or accusing the patient of wrong doing.2 Estimated adherence rates to long-term therapies are staying steady with around 50% of patients not fully taking medications as prescribed.2 Concern about adherence has been increasing due to the growing burden of chronic disease. Additionally, adherence is particularly low in children and young people,1 increasing service use and healthcare costs. Factors affecting adherence in children and young people have been the subject of many studies, most of which concluding that there are multiple factors to consider, summarised in figure 1. The main factors of focus in this article are caregiver factors, individualistic factors, peer support and healthcare factors.

    Figure 1

    Key factors affecting adherence in the paediatric population, demonstrating the complicated nature of non-adherence.

    Caregiver factors

    Treatment of children is complicated by the triangle of communication between patient, professional and parent.3 Healthy family dynamics promote adherence, with good family communication and structured routines correlating with least child resistance.3 It also follows that the converse can be important factors contributing to poor adherence in children with complex family lives. During the younger years, caregivers hold more responsibility for adherence, making the following factors of particular interest in these age groups. First, knowledge about medication usefulness is known to be important,4 with parents more likely to …

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    Footnotes

    • Funding None declared.

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.