Pediatric adherence: Conceptual and methodological considerations

This article highlights conceptual and methodological challenges inherent in the study of pediatric adherence. Key conceptual issues include the participation of parents in treatment, the complexity of treatment plans, and the active role parents and children play in determining how treatment is managed. Key methodological issues involve weighing the advantages and disadvantages of available measurement options and obtaining a standard of comparison. Difficulties inherent in defining a standard of comparison have led investigators to propose examining levels of self-care behaviors. The drawbacks to assessing self-care behaviors are highlighted and the practice of comparing reported treatment-related behaviors to actual prescriptions is encouraged. Recommendations for both research and clinical practice are offered.