A Systematic Review of Adherence-Enhancing Interventions in Adolescents Taking Long-term Medicines

Purpose: To assess the effectiveness of adherence-enhancing interventions (AEIs) aimed at adolescents (10-19-year-olds). Methods: An extensive search of seven bibliographic databases was conducted at the end of 2009 to identify comparative studies evaluating AEIs targeting adolescents. Data describing study characteristics and intervention effects on adherence to medicines or health outcomes were extracted and summarized using qualitative and quantitative methods. Results: A total of 17 AEIs were identified: 12 studies (70%) were conducted in the United States, 10 (59%) included adolescents with type 1 diabetes mellitus, and 14 (82%) considered the developmental tasks of adolescence. In all, 12 AEIs successfully improved outcome measures. Features of successful interventions included targeting AEIs to a narrow age range, including family in type 1 diabetes mellitus management, and improving access to care. Poor quality and underpowered studies limit the inferences drawn from this review. Conclusions: More diverse and robust studies are needed to identify strategies to help adolescents manage medicines. (C) 2011 Society for Adolescent Health and Medicine. All rights reserved.