Treatment Adherence in Pediatric Eosinophilic Gastrointestinal Disorders

Objective Examine treatment adherence rates in pediatric eosinophilic gastrointestinal disorders (EGID). Methods Participants were children aged 2.5-18 years with eosinophilic esophagitis or eosinophilic gastroenteritis (EGE) and their caregivers. A multimethod, multi-informant assessment including parent report and electronic monitoring was utilized, with a 90% cut point for nonadherence. Results Medication nonadherence prevalence was 30%. Adherence frequency was 91% +/- 14% (0-100%) per parent report and 100% +/- 69% (0-194%) per electronic monitors. Tube-feeding adherence was 99% +/- 3%. Food allergen exposures were less than 1 per 2 weeks, with 33% nonadherence prevalence. Patients with EGE and toddlers with both conditions demonstrated poorer medication adherence (p's < .05). Caregivers reported higher number of missed medication doses than food exposures (p < .05). Conclusions The prevalence and range of nonadherence demonstrates that subsets of these patients are nonadherent. Adherence to treatment in EGID is complex and multifaceted, with nonadherence varying across treatments.