Main areas which have been identified as potentially interfering with adherence29–31,34,35,40 and strategies to improve compliance/adherence27,30,32,38,39
| Identified areas | Strategies |
|---|---|
| Factors related to the adolescent | |
| Cognitive factors | Provide information meeting the adolescent’s maturational stage |
| Perception of the disease | Take into account underlying psychological factors |
| Emotional/psychological factors | Tailor the treatment to the patient’s individuation process and stage |
| Patient education | Communicate information in a straightforward way, trust the adolescent, do not hesitate to correct wrong ideas |
| Tailor the doses of the medication to the patient’s physiological status (puberty/growth) | |
| Adapt the therapy to the adolescent’s lifestyles | |
| Ask for proposals from the patient | |
| Factors related to the teenager’s environment | |
| Family functioning | If needed, suggest the support of siblings, peers |
| Peer influence | |
| Factors related to the setting and communication | |
| Setting | In each setting (paediatric or adult) keep the same professionals in charge of the same patients over time |
| Relationship with the healthcare team, communication style | Assess adherence regularly and in a non-threatening manner, check for side effects |
| Complexity of the therapeutic regimen | Simplify the therapeutic regimen as much as possible, negotiate |
| Interference of the treatment with the adolescent’s needs and lifestyles | |