Factors affecting compliance of drug therapy in outpatient children

Authors

  • Vikram R. Goudar Department of Pediatrics, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India
  • Mahantesh Matti Department of Pediatrics, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India
  • Vijay Kulkarni Department of Pediatrics, SDM College of Medical Sciences and Hospital, Dharwad, Karnataka, India

DOI:

https://doi.org/10.18203/2349-3291.ijcp20194557

Keywords:

Adherence, Children, Compliance, Drug, Medication, Taste

Abstract

Background: Adherence to a medical treatment regimen is an essential determinant of clinical success and professional success of doctor as well. Compared with the thousands of trials for individual drugs and treatments, there are few relatively rigorous trials of adherence interventions. Our study is a small effort towards understanding reasons for poor compliance among paediatric patients.

Methods: The 256 cases that were selected for study had various clinical conditions. Compliance definition was applied only for those who received antibiotics. For other cases who received drugs other than antibiotics, we asked number of skipped doses. Data collected by paediatrician during follow-up or next visit because of some other illness and by telephone call to parents by assistant. Parents and kids were asked about the reasons for skipping the doses and also about their personal preferences towards medicines.

Results: Out of 256 children 93 were prescribed antibiotics, 37.63% had good compliance and 62.36% had poor compliance.7% never skipped any medicine, 62% skipped less often (≤5 times) and 31% skipped. Very often (≥6 times), taste (67%), quantity (52%), apparent recovery (62%), school (65%), sleeping (56%), timing with food (47%) and bottle getting finished (49%) were the most common reasons for missing the dose of any medicine. Adherence was better when less number of doses were given less often. Chocolate flavor was liked by most kids.

Conclusions: Prescribing medications should involve parents, children and practitioners in an open discussion around the most suitable, palatable formulations for successful treatment outcomes.

References

El-Rachidi S, Larochelle JM, Morgan JA. Pharmacists and pediatric medication adherence: bridging the gap. Hospital pharmacy. 2017 Feb;52(2):124-31.

Santer M, Ring N, Yardley L, Geraghty AW, Wyke S. Treatment non-adherence in pediatric long-term medical conditions: systematic review and synthesis of qualitative studies of caregivers’ views. BMC Pediatr. 2014 Dec;14(1):63.

Gardiner P, Dvorkin L. Promoting Medication Adherence in Children. Am Fam Physician. 2006 Sep 1;74(5):793-8.

Penkower L, Dew MA, Ellis D, Sereika SM, Kitutu JM, Shapiro R. Psychological distress and adherence to the medical regimen among adolescent renal transplant recipients. Am J Transplantation. 2003 Nov;3(11):1418-25.

CHMP. Reflection paper: formulations of choice for the paediatric population.

Available at: http://www.emea.europa.eu/pdfs/human/paediatrics/19481005en.pdf

Matsui D. Assessing the palatability of medications in children. Paediatric and Perinatal Drug Therapy. 2007 Sep;8(2):55-60.

Schwartz RH. Enhancing children's satisfaction with antibiotic therapy: a taste study of several antibiotic suspensions. Current therapeutic research. 2000 Aug 1;61(8):570-81.

Cohen R, de La Rocque F, Lécuyer A, Wollner C, Bodin MJ, Wollner A. Study of the acceptability of antibiotic syrups, suspensions, and oral solutions prescribed to pediatric outpatients. Europ J Pediatr. 2009 Jul 1;168(7):851-7.

Penza‐Clyve SM, Mansell C, McQuaid EL. Why don't children take their asthma medications? A qualitative analysis of children's perspectives on adherence. J Asthma. 2004 Jan 1;41(2):189-97.

Sunakawa K, Akita H, Iwata S, Sato Y, Fujii R. Rational use of oral antibiotics for pediatric infections. Infection. 1995 Mar 1;23(2):S74-8.

Al-Shammari SA, Khoja T, Al-Yamani MJ. Compliance with short-term antibiotic therapy among patients attending primary health centres in Riyadh, Saudi Arabia. J Royal Society Health. 1995 Aug;115(4):231-4.

Baguley D, Lim E, Bevan A, Pallet A, Faust SN. Prescribing for children-taste and palatability affect adherence to antibiotics: a review. Arch Dis Child. 2012;97(3):293-7.

Ishizaka T, Miyanaga Y, Mukai J, Asaka K, Nakai Y, Tsuji E, et al. Bitterness evaluation of medicines for pediatric use by a taste sensor. Chem Pharmaceutical Bulletin. 2004;52(8):943-8.

Block SL, Schmier JK, Notario GF, Akinlade BK, Busman TA, MacKinnon III GE, et al. Efficacy, tolerability, and parent reported outcomes for cefdinir vs. high-dose amoxicillin/clavulanate oral suspension for acute otitis media in young children. Cur Med Resea Opinion. 2006 Sep 1;22(9):1839-47.

Frush KS, Luo X, Hutchinson P, Higgins JN. Evaluation of a method to reduce over-the-counter medication dosing error. Archi Pediatr Adolescent Med. 2004 Jul 1;158(7):620-4.

Downloads

Published

2019-10-21

Issue

Section

Original Research Articles