The Efficacy of Adherence Interventions for Chronically Ill Children: A Meta-analytic Review

Abstract

Children with chronic illness, on average, have low rates of adherence to their medical regimens despite the possible medical and psychological consequences. Many different interventions have been developed to increase adherence in this population, and the results are mixed. Some studies show strong results, while others only slightly increase adherence. The purpose of this meta-analysis was provide quantitative information about the overall effectiveness of adherence interventions for children with a chronic illness, as well as statistically evaluate potential moderators of the effectiveness of interventions (e.g., behavioral vs. educational interventions, age of child). Overall, adherence interventions for children with chronic illnesses appear to effectively increase adherence and maintain benefits at follow-up. Additionally, these adherence interventions overall appear to have some positive health benefits. Some intervention and methodological variables, such as study design and assessment method, had a significant effect on effect sizes. However, most of the data included in this meta-analysis should be interpreted with caution because of high levels of heterogeneity within the data. This suggests that more targeted summaries of the research (i.e., adolescents with asthma) would provide more useful information about the effectiveness of adherence interventions.