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

Alexandra L. Quittner, Avani C. Modi, Kathleen L. Lemanek, Carolyn E. Ievers-Landis, Michael A. Rapoff

Research output: Contribution to journalReview articlepeer-review

212 Scopus citations


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.

Original languageEnglish (US)
Pages (from-to)916-936
Number of pages21
JournalJournal of pediatric psychology
Issue number9
StatePublished - Oct 2008


  • Adherence
  • Diary methods
  • Electronic monitors
  • Empirically-supported
  • Measurement

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Pediatrics, Perinatology, and Child Health


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