Trials utilising behavioural interventions (with or without education)
| Study | Age group | Clinical group | No | Intervention | Control | Study period | Adherence measure | Key adherence findings | Delphi score |
|---|---|---|---|---|---|---|---|---|---|
| Hovell et al29 | Adolescents (12–19 years) | Tuberculosis treatment | 286 | Behavioural management | Group 1: Self-esteem counselling | 9 months | Missed 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 involvement | Group 2: Usual treatment | ||||||||
| Smith et al38 | Children and adolescents (1–16 years) | Asthma | 217 | Education (written) + behavioural management (linking medication with routines, adherence monitoring) | Usual treatment | 9 months | Missed doses (self-report questionnaire) | Intervention superior to control (d=0.93) | 4 |
| Bonner et al28 | Children and adolescents (4–19 years) | Asthma | 119 | Education (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 treatment | 3 months | Perceptions (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 al39 | Children and adolescents (<16 years) | Epilepsy, (+low drug serum levels) | 70 | Education (group education for mothers) Behavioural management (verbal commitment for the mother to take active role in managing child's health) | Usual treatment | 5 months | Blood testing for drug | Intervention superior to control for per protocol analysis (d=0.81) (trend only for intention to treat, d=0.44) | 2 |
| Rapoff et al40 | Children and adolescents (2–16 years) | Juvenile rheumatoid arthritis | 54 | Education (written and verbal) + behavioural management (supported by fortnightly phone contact) | Education (written and verbal, via fortnightly phone contact | 13 months | MEMS | Intervention superior to control for adherence (d=0.75). No significant group differences for clinical outcomes | 4 |
| Berkovitch et al27 | Children (9–84 months) | Sickle cell prophylaxis | 45 | Education (slideshow on disorder and management + behavioural management (calendar with sticker reward system) + home visits (weekly visits by social worker for 2 months) | Usual treatment | 6 months | MEMS | No significant group differences after 2-month intervention (d=0.49) or after further 2 months monitoring (d=0.53) | 4 |
| Fennell et al26 | Children and adolescents (5–18 years) | Renal transplant | 29 | Education (booklet, discussion and video). | Usual treatment | 3 months | Blood testing for ciclosporin and pill counts for other drugs | Intervention 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.