Empirically Supported Treatments in Pediatric Psychology: Regimen Adherence

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ObjectiveTo review empirical studies of psychological interventions for nonadherence to medical regimens for three chronic illnesses: asthma, juvenile rheumatoid arthritis (JRA), and type 1 diabetes.MethodsThe Chambless criteria for “promising,” “probably efficacious,” or “well-established” were applied to 8 intervention studies on asthma, 4 on JRA, and 11 on type 1 diabetes.ResultsFor asthma, organizational strategies appear probably efficacious in promoting adherence, whereas educational and behavioral strategies appear promising. For JRA, behavioral strategies appear probably efficacious in improving adherence. For type 1 diabetes, multicomponent packages and operant learning procedures appear probably efficacious, whereas cognitive-behavioral strategies appear promising. No interventions were identified as “well-established.”ConclusionsFuture studies will need to develop adequate definitions of adherence, accurate methods of assessing adherence, and appropriate designs to evaluate multicomponent treatment programs to advance interventions to the “well-established” category.

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