The Role of Adherence on Health Outcomes in Pediatric Chronic Conditions: A Meta-Analysis

Abstract

Increased adherence to medical regimens has been suggested to lead to improved health outcomes. It is unknown what level of adherence is necessary to achieve improved health in different pediatric chronic conditions. In this study, a meta-analysis was carried out to explore the relationship between adherence and health outcomes across pediatric chronic conditions. Twenty-six studies utilizing correlational data were included in the meta-analysis. Results indicated a relationship between adherence and health outcomes, in that lower levels of adherence are related to negative health outcomes (overall effect size d=-0.47). There was significant heterogeneity across studies in the meta-analysis (Q=465.82) and all potential moderators demonstrated significant heterogeneity (i.e. disease, health outcome measurement, and adherence measurement method). The meta-analysis did not determine cut-points for specific pediatric chronic conditions and this should be an area of future research as it could assist physicians in more effective treatment planning. The use of intervention studies is encouraged as these provide a more powerful demonstration of the relationship between adherence and health outcomes.