Table 2

Trials utilising behavioural interventions (with or without education)

StudyAge groupClinical groupNoInterventionControlStudy periodAdherence measureKey adherence findingsDelphi score
Hovell et al29Adolescents (12–19 years)Tuberculosis treatment286Behavioural managementGroup 1: Self-esteem counselling9 monthsMissed doses (face-to-face interview)Intervention superior to both group 1 control (d=0.39, 9 months) and group 2 control (d=0.44, 9 months)6
Monthly meetings incorporating advice about adherence, contingency contracting, problem solving, goal setting, developing routines and family involvementGroup 2: Usual treatment
Smith et al38Children and adolescents (1–16 years)Asthma217Education (written) + behavioural management (linking medication with routines, adherence monitoring)Usual treatment9 monthsMissed doses (self-report questionnaire)Intervention superior to control (d=0.93)4
Bonner et al28Children and adolescents (4–19 years)Asthma119Education (group) + behavioural management (symptom monitoring, linking symptoms with patterns of preventer use, action plans, coaching for symptom history detection and reporting, provided by dedicated family worker for 3 months)Usual treatment3 monthsPerceptions (4 items assessing history of running out of medicines and administration practices)Intervention superior to control for adherence scores (d=0.79)4
Shope et al39Children and adolescents (<16 years)Epilepsy, (+low drug serum levels)70Education (group education for mothers) Behavioural management (verbal commitment for the mother to take active role in managing child's health)Usual treatment5 monthsBlood testing for drugIntervention superior to control for per protocol analysis (d=0.81) (trend only for intention to treat, d=0.44)2
Rapoff et al40Children and adolescents (2–16 years)Juvenile rheumatoid arthritis54Education (written and verbal) + behavioural management (supported by fortnightly phone contact)Education (written and verbal, via fortnightly phone contact13 monthsMEMSIntervention superior to control for adherence (d=0.75). No significant group differences for clinical outcomes4
Berkovitch et al27Children (9–84 months)Sickle cell prophylaxis45Education (slideshow on disorder and management + behavioural management (calendar with sticker reward system) + home visits (weekly visits by social worker for 2 months)Usual treatment6 monthsMEMSNo significant group differences after 2-month intervention (d=0.49) or after further 2 months monitoring (d=0.53)4
Fennell et al26Children and adolescents (5–18 years)Renal transplant29Education (booklet, discussion and video).Usual treatment3 monthsBlood testing for ciclosporin and pill counts for other drugsIntervention superior to control for one medication (prednisone) but not others (azathioprine and ciclosporin)0
Behavioural management (medication calendar and rewards for adherent behaviour)
  • * Effect size equivalent calculated from OR.

  • Data presented in the article do not permit calculation of effect sizes.