From: Improving adherence to medical regimens for juvenile rheumatoid arthritis
Recommendations for Enhancing Adherence in Pediatric Rheumatology |
1. Educate patients and families about the goals of treatment. Negotiate with them upfront about which treatments they are willing to try. |
2. Make regimens as simple as possible and consistent with the patients' daily routine. |
3. Educate patients and families about how to minimize treatment side effects and problem solve with them to address other barriers to adherence. |
4. Ensure that patients and families have the requisite behavioral skills to implement regimens. Rehearse these in the clinic (e.g., demonstrate and have patients practice therapeutic exercises). |
5. Encourage patients and caregivers to monitor adherence (e.g., use a calendar posted in a prominent place in the home). |
6. Teach caregivers positive reinforcement strategies for promoting adherence (e.g., point system for adhering to regimen components). |
7. Review discipline strategies with caregivers for children who are oppositional (e.g., time-out for younger child who refuses medications). |
8. Teach older patients self-management strategies (e.g., problem-solving). |
9. Refer patients and families to qualified mental health providers if more serious problems exist concurrently with nonadherence or are directly interfering with adherence. |