Identifying barriers to adherence in pediatric transplantation
Simons, Laura Edith
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Eighty adolescent solid organ transplant recipients participated in a study designed to measure the degree to which barriers, a fundamental tenet in the Health Belief Model (HBM; Strecher & Rosenstock, 1997), predicted medication adherence. The Parent Medication Barriers Scale (PMBS) and Adolescent Medication Barriers Scale (AMBS) scales were designed to assess perceived barriers. Principle components factor analyses resulted in the following subscales for both measures: 1) Disease Frustration/Adolescent Issues, 2) Regimen Adaptation/Cognitive, 3) Ingestion Issues, and 4) Parent Reminder (parent scale only). Nomological validity was established with significant associations between disease and medication regimen variables (e.g., side effects, number of medications, time since transplant) and barrier scale scores. In addition, adolescent barrier scale scores were significantly associated with family functioning in the expected direction. Criterion validity was established with statistically significant associations between higher barrier scale scores and medication nonadherence. The predictive value of barriers on medical nonadherence was examined with adolescent issues and parent reminders significantly predicting adherence classification. This study provides a brief and valid method to assess barriers to medication adherence in adolescent transplant recipients.