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A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness
  1. Angela J Dean1,2,3,
  2. Julie Walters4,
  3. Anthony Hall4,5
  1. 1Kids in Mind Research, Mater Child and Youth Mental Health Service, Mater Children's Hospital, South Brisbane, Australia
  2. 2The University of Queensland, Queensland Brain Institute, St Lucia, Australia
  3. 3The University of Queensland, School of Medicine, Herston, Australia
  4. 4Mater Pharmacy Services, South Brisbane, Australia
  5. 5Griffith University, School of Pharmacy, Australia
  1. Correspondence to Dr Angela J Dean, Kids in Mind Research, Mater Child and Youth Mental Health Service, Mater Children's Hospital, South Brisbane, Queensland 4101, Australia; a.dean{at}


Introduction Poor medication adherence is common in children and adolescents with chronic illness, but there is uncertainty about the best way to enhance medication adherence in this group. The authors conducted a systematic review of controlled trials examining interventions that aim to improve medication adherence.

Method A comprehensive literature search was undertaken to locate controlled trials that described specific interventions aiming to improve adherence to long-term medication, where participants were aged 18 years and under, medication adherence was reported as an outcome measure, and which could be implemented by individual health practitioners. Studies were reviewed for quality and outcome.

Results 17 studies met inclusion criteria: seven studies examined educational strategies, seven studies examined behavioural interventions and three studies examined educational intervention combined with other forms of psychological therapies. Only two of seven studies reported a clear benefit for education on medication adherence, whereas four of seven trials indicated a benefit of behavioural approaches on medication adherence. One trial reported that combining education with behavioural management may be more effective than education alone. Studies which combined education with other non-medication specific psychological interventions failed to demonstrate a beneficial effect on medication adherence. Only two studies examined adherence-promoting interventions in young people with established adherence problems.

Conclusion These findings suggest that education interventions alone are insufficient to promote adherence in children and adolescents, and that incorporating a behavioural component to adherence interventions may increase potential efficacy. Future research should examine interventions in high-risk groups.

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  • Funding Evidence-based Practice Unit, Queensland Health, Queensland Health Building, 147–163 Charlotte Street, Brisbane Queensland 4000, Australia.

  • Competing interests None.

  • Provenance and peer review Not commissioned; externally peer reviewed.