Karla Vaz, MD, MEd
Cincinnati Children's Hospital Medical Center
Approximately 65-88% of adolescents are nonadherent to treatment regimens. In pediatric inflammatory bowel disease (IBD) medication nonadherence rates are 50-88% across medications. Improving education in patients with chronic diseases has been shown to improve coping and to improve adherence to treatment in adults with IBD. Therapeutic patient education (TPE) has been used in patients with chronic diseases such as asthma, diabetes, obesity and atopic dermatitis to train patients in the skills of self-managing or adapting treatment to their particular chronic disease, and in coping processes and skills. In this pilot, mixed-methods study we sought to evaluate the effect of TPE with a new guide-The IBD Pocket Guide on medication adherence, IBD knowledge and transition readiness in adolescents aged 11-18 years. Medication adherence was monitored using a MedMinder® Pill Dispensing system. Participants who were <90% adherence during a 4 week run-in phase were randomized to either a normal care group or an educational intervention (EI) group. Participants were followed for an additional 4 weeks after intervention. Trends were found in the EI to suggest improved medication adherence as well as improved IBD knowledge. Patients in the EI group had significantly improved knowledge on osteoporosis (p=0.0476). Qualitative data showed that participants did not like the use of the large pillbox, but did perceive that they had improved knowledge after the educational intervention. Future studies will need to recruit a larger number of patients to reach significance. In conclusion, therapeutic patient education may be beneficial for improving patient medication adherence and IBD knowledge.
