Factors Affecting Treatment Regimen Adherence in Children and Adolescents with Asthma

Treatment regimen adherence is a well-documented problem in pediatric psychology. The literature is replete with studies indicating that adherence in pediatric chronic illnesses is significantly correlated with several family- and child-related psychosocial variables. The current work proposed and tested a model of treatment regimen adherence (as defined asprescription refill rate with physiological outcome as a covariate) for children and adolescents with asthma. The results suggest that although none of the proposed model variables (attention deficit-related behavior, secondary gain, family life stress, and child-reported illness attitudes) is a significant predictor of adherence, secondary gain does moderate the relationship between asthma severity and adherence (with peak flow as a covariate). More specifically, a significant positive correlation between severity and adherence exists only when secondary gain is low; otherwise, the correlation is non-significant. The optimal linear combination of participant age, secondary gain, child-reported illness attitudes, family stress, and attention-related behavior problems is not a significant predictor of prescription refill rate when physiological outcome is covaried from refill rate. This finding is consistent with the notion that outcome is in some way related to adherence and should not be considered a nuisance or control variable.