MON-128 Improving Medication Adherence in Pediatric Patients

Abstract

Introduction Caring for chronic pediatric endocrine disorders commonly require long-term use of pharmacotherapy. Although these medications are effective in combating disease, their real benefits are often not achieved because of non-adherence. Health care professionals must be aware to the high prevalence of noncompliance which contributes to increased morbidity and medical complications, poorer quality of life and an overuse of the health care system and increase health care costs. Methods In order to better understand the factors contributing to noncompliance in our patient population, we performed a cross -sectional study along with medical chart review. We randomly selected 30 endocrine charts with chronic disorders and reviewed documentation of the need for medications, type of the visit, dose, duration, plan, patient compliance and refill follow up. Special attention was made if the physicians documented discussing the possible side-effects of the medication. An anonymous survey was handed to the parents at the end of visit and form was dropped in a locked box. No personal information or identification was collected. Parents were inquired about their understanding of the need for medication, side effects, compliance and the reason for poor compliance if they met the criteria. The chart reviewed showed that 47% of the patients reported poor compliance to physician during visit but when asked during the survey only 22 % reported poor compliance. 58% of the patients reported not knowing the possible side-effects of the medications. Reasons for non-compliance given by patients were 58% concerned about side effects of medication, refill not provided 4.8%, forgetting to take medication 2.4%, cost 2.4%, and language barrier 2.4%. Other 30% didn’t provide a specific reason for poor compliance. Conclusion Rates of medication adherence in pediatric patient with chronic medical illness range from 11% to 93%, with an estimated average of around 50%. Our population compliance correlates with the national average for pediatric population compliance. Our study also highlighted the importance of discussing possible side-effects with patients. Reviewing it periodically during clinic visits may decrease the risk of non-compliance. 58% of our patients reported lack of knowledge of proper side-effects of the treatment and impact of non -compliance to disease progression. Based on these results, we provided additional resources to physicians to better screen for factors that may affect compliance in each visit. Certain hard stops were added in medical documents and modifications were done in EMR. Information about common endocrine conditions and medication was added in EMR in English and Spanish. Physicians were encouraged to given written information about the proper use and side-effects. We are planning to do a follow up survey in 3–4 months to evaluate the improvement.