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Title: A 360-degree appraisal of the barriers to medication adherence in paediatric patients with long-term illness
Author: Ullah, Nafeesa
ISNI:       0000 0004 7427 0759
Awarding Body: University of Brighton
Current Institution: University of Brighton
Date of Award: 2017
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Research indicates that paediatric medication adherence in long-term conditions is often sub-optimal and can be affected by a range of developmental, social and family factors. However, little is known about children’s medication-taking experience. The aim of this research was to identify the most common barriers to adherence from the perspective of three different groups: the medicine-taker, the medicine giver and the healthcare professional (HCP). A further aim was to evaluate the role of community pharmacists in supporting paediatric patients with long-term medication needs. Study one conducted a systematic review of seven databases from January 1995 to 2016, yielding 18 studies that used self-report methods to identify barriers to medication adherence in children and adolescent, aged 5-18 years with long-term conditions. The common barriers were a lack of caregiver and healthcare support, medication regimen complexity, forgetfulness, medication side-effects and concerns about medication need and efficacy. Stigma was the only condition-specific adherence barrier for children and adolescents with HIV, all other barriers were uniform across conditions. Study two used a Delphi method with paediatric healthcare professionals (N=23) to prioritise adherence barriers in current clinical practice. Agreement was rated on a 5-point scale, the mean and standard deviation was used to determine consensus between participants to each adherence barrier. The main observed barriers to adherence were the need for constant reminders from caregivers to ensure medication was taken, medicationtaking fatigue, medication taste and increased responsibility for medication-taking. The results indicated that there is a variation between the barriers identified through paediatric self-reports and what is observed by healthcare professionals in practice. Study three used a retrospective questionnaire to identify caregivers (N=52) barriers to medication administration and their opinions of community pharmacists. Common barriers identified were their child’s heavy reliance on them to ensure medication was taken, frustration and fatigue from having to take regular medication and their child’s increased responsibility for medication-taking. Caregivers were generally positive about the support they received from the pharmacist to care for their child with long-term medication needs and would welcome medication reviews and information sessions with the pharmacist to help with their child’s adherence.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available