Strategies to Improve Insulin Adherence in Adolescents With Type 1 Diabetes

Abstract

The Pediatric Endocrinology Nursing Society (PENS) is committed to the development and advancement of nurses in the art and science of pediatric endocrinology nursing and to improve the care of all children with endocrine disorders through the education of the pediatric Type 1 diabetes (T1DM) is a serious health condition with the potential for significant morbidity and mortality, and economic burden (Stanger et al., 2013). Poor medication adherence is a common problem in adolescents with a chronic health condition, resulting in adverse health outcomes (Dean, Walters, & Hall, 2010; Hanghoj & Boisen, 2014). Medication adherence is crucial to survival for the T1DM adolescent and is an important aspect of care to minimize long-term complications. According to the Centers for Disease Control and Prevention, the incidence of T1DM in adolescents ages 12 to 19 is approximately 1 in 500, with significantly poorer adherence to medication than in adults (Stanger et al., 2013). Adherence is defined as the extent with which a person follows recommendations from the health care provider, and medication adherence is defined as the extent with which a person takes medications as prescribed by the health care practitioner (Dean et al., 2010). Evidence from the pivotal Diabetes Control and Complications Study documents the association between intensive insulin management and good glycemic control (Hood, Peterson, Rohan, & Drotar, 2009). However, the process is difficult for most adolescents, due in part to the changing insulin requirements as a result of puberty and insulin resistance in adolescence, but more importantly due to “the imperfect nature of the treatment regimen, and psychosocial variables” producing a negative effect upon glycemic control (Hood et al., 2009, p. e1172).