Treatment Adherence in Adolescents with Chronic Illness: The Dyadic Experience of Adolescents and their Parents and the Efficacy of Psychological Interventions

Odgers, Kelsey (2021) Treatment Adherence in Adolescents with Chronic Illness: The Dyadic Experience of Adolescents and their Parents and the Efficacy of Psychological Interventions. Doctoral thesis, University of East Anglia.

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Abstract

Background: Increasing numbers of adolescents are living with chronic illnesses which require adherence to multiple daily behaviours. Difficulties with adherence are common in every patient group. However, adolescents have higher rates of non-adherence than child and adult samples. Understanding the lived experience of managing adherence and the efficacy of interventions to promote adherence in adolescents is therefore imperative. Aims: The first aim of this thesis was to explore the adolescent-parent dyadic experience when managing adherence to treatment in chronic illness. A second aim was to explore the efficacy of psychological interventions in promoting adherence to treatment, quality of life and family functioning in adolescents with chronic illness.
Methods: A systematic review of qualitative studies that explored adolescents and their parents’ experiences of managing adherence was conducted. A second systematic review and meta-analysis was conducted which synthesised and pooled effect sizes from RCTs that examined the efficacy of psychological adherence-promoting interventions. Results: Five ‘analytic’ themes were identified from nine studies in the qualitative systematic review. These highlighted the importance of relational factors including trust, negotiation and collaboration in enabling the dyad to manage adherence. Thirty-six studies were included in the second review. Several had missing data and were rated as high risk of bias. Nevertheless, significant small effects were found for adherence and quality of life outcomes at posttreatment. Follow-up, moderation and subgroup analyses were limited by the number of studies.
Conclusion: Future high-quality research, including qualitative research exploring the lived experience of adherence to treatment and adherence-promoting intervention research, is needed. Research should recruit adolescent samples with identified poor adherence across a range of chronic illnesses.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Jackie Webb
Date Deposited: 19 Nov 2021 12:03
Last Modified: 19 Nov 2021 12:03
URI: https://ueaeprints.uea.ac.uk/id/eprint/82235
DOI:

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