Volitional Non-adherence in Pediatric Asthma: Its occurrence and relation to disease severity and self-efficacy

Abstract

Recent adherence theories have diverged to include two subtypes of non-adherence: inadvertent (e.g., forgetting) and volitional. Volitional non-adherence focuses on deliberate changes that patients and families make to their prescribed medication regimens. The purpose of this study was to (a) describe the types of changes parents make to their child's asthma regimen and the motivating factors for those changes, and (b) explore potentially related medical and psychological factors. Findings indicated that approximately 80% of parents reported making purposeful changes to their child's asthma regimen and that the majority of these changes involved decreasing prescribed medications. Furthermore, the most commonly reported reasons for making changes to medications included a desire to reduce treatment burden, control symptom exacerbations, and improve quality of life. Lastly, findings indicated that parents who were volitionally non-adherent did not differ significantly with regard to perceived self-efficacy for asthma management and disease severity when compared to parents who reported being adherent. This study highlights the importance of considering and incorporating the family's view and overall treatment goals when prescribing treatment regimens.