Pediatric Nonadherence. A Solutions Based Approach - Ida Dancyger;Victor Fornari;Peter Silver

Nonadherence to pediatric recommendations is a pervasive challenge to the growth, development, and wellbeing of children. Nearly half of all youth and their parents suffer the consequences of misunderstanding, forgetting, ignoring or refusing professional medical advice regarding children.  Addressing this widespread dilemma, this unique and comprehensive title explores a variety of different pediatric problems that impact children, adolescents and their families. Clinical case vignettes are provided to highlight particular considerations, and a description of the most up-to-date strategies to solve the dilemma of nonadherence to pediatric care is provided.   Indeed, technology is emphasized as an important and innovative means of tracking, interfacing and gathering individual data and facilitating improved pediatric adherence.

No one intervention strategy can be applied to solve nonadherence of pediatric patients. Research studies have concluded that successful efforts to enhance adherence rely on a number of important elements. First and foremost is nurturing a trusting relationship between the patient, the family and the clinician, which strengthens the therapeutic alliance. Following that is making sure that the patient and family fully understand the nature of the illness and the recommendations. Effective and clear communication is critical between the health professionals, the patient and the family. When the health professional understands who the patient and the family are on a deeper level, then adherence may be improved. It is imperative that the clinicians take into account the individual patient and families’ cultural, social and community context, as well as their beliefs and support systems. An atmosphere of shared collaboration and mutual respect will improve open communication and the promotion of adherence and positive outcomes. An important thread throughout each chapter is the impact of health care disparities, diversity and equity.

The contributors to Pediatric Nonadherence represent a wide range of nationally and internationally recognized experts in their area of pediatric sub-specialization and practice. A major contribution to the clinical literature, this timely title will be of great interest to pediatricians, family practitioners, medical students, residents, fellows, physician assistants, and nurse practitioners.