For children, skipped meds often lead to hospital visits

September 10, 2013

Poor medication adherence causes more frequent hospitalizations and emergency department visits among children and adolescents who have a chronic medical condition, such as asthma and type 1 diabetes, according to a study recently published in Pediatrics.

Poor medication adherence causes more frequent hospitalizations and emergency department (ED) visits among children and adolescents who have a chronic medical condition, such as asthma and type 1 diabetes, according to a study recently published in Pediatrics.

Lead author Meghan McGrady, PhD, of the Division of Behavioral Medicine and Clinical Psychology at Cincinnati Children’s Hospital Medical Center, and co-author Kevin Hommel, PhD, wanted to gauge the long-term healthcare utilization consequences of children with chronic illnesses not taking their medicine.

The authors conducted a systematic review of articles published in peer-reviewed journals using PubMed, PsycINFO, and CINAHL databases. Ten articles that examined the relationship between adherence and healthcare utilization in youth with a chronic medical condition were included.

More than half of children with a chronic illness are put on medication, but past studies have found anywhere from 50% to 88% don't take their medications as prescribed.

Nine of the studies included children with asthma and the 10th focused on those with type 1 diabetes. Most studies looked at kids between aged 2 and 18 years; 1 included young adults up to age 29. Pharmacy refill records, family questionnaires, and electronic monitors were used to track children’s medication use, Reuters reported.

“This study illustrates the importance of assessing and addressing adherence as part of medical care,” McGrady said. “Non-adherence is a prevalent and modifiable behavior that, if targeted, may improve health outcomes and reduce healthcare use in children and adolescents with a chronic medical condition.”

Intervention efforts targeting adherence may result in reduced healthcare utilization, and ultimately, lower healthcare costs, she said.

Given the increases in U.S. healthcare spending, it is important to understand potentially modifiable contributors to healthcare utilization and costs, McGrady said.

“Nonadherence is a prevalent and modifiable behavior that has been linked to excess healthcare use and $100 to $300 billion in excessive healthcare costs in adults,” she said. “Given the increasing number of children and adolescents diagnosed with a chronic medical condition, we wanted to investigate whether a similar relationship existed in pediatric populations.”