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Pharmacotherapy Adherence for Pediatric Anxiety Disorders: Predictors and Relation to Child Outcomes

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Abstract

Background

Pharmacotherapy is considered an evidenced-based treatment for anxious youth. There is a need to better understand the relation between medication adherence and child outcomes.

Objective

This study prospectively examined: (1) baseline predictors of adherence and (2) the relation between medication adherence and clinical outcomes in children and adolescents with anxiety disorders.

Method

Participants were 349 youth randomized to sertraline, pill placebo, or sertraline plus cognitive behavioral therapy in the Child/Adolescent Anxiety Multimodal Study and followed over 12 weeks. The measure of pharmacotherapy adherence used was pharmacotherapist (PT) ratings of adherence at each session. Four domains of baseline predictors were examined (demographics, child clinical variables, family/parent variables, and treatment variables).

Results

Multiple regression analyses revealed few significant predictors of adherence. The most robust predictors of greater adherence were living with two parents and parents’ positive expectations that medication would lead to better outcomes. PTs ratings of higher adherence predicted higher global functioning at post treatment and treatment responder status.

Conclusions

In order to increase adherence, improving expectations and instilling hope for positive outcomes and problem solving ways to overcome pragmatic barriers associated with single parent families is recommended.

ClinicalTrials.gov Number

NCT00052078.

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Acknowledgements

This research was supported the National Institute of Mental Health Grants U01MH64089, U01MH64107, U01MH64003, U01MH63747, U01MH064092, and U01MH64088 awarded to the PIs of the Child/Adolescent Anxiety Multimodal Study.

Author information

Authors and Affiliations

  1. Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA

    Asima Zehgeer, Golda S. Ginsburg & Phyllis Lee

  2. Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, PA, USA

    Boris Birmaher & Dara Sakolsky

  3. Department of Psychiatry, Ann and Robert H. Lurie Children’s Hospital, Chicago, IL, USA

    John Walkup

  4. Department of Psychology, Temple University, Philadelphia, PA, USA

    Philip C. Kendall

  5. Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA

    Tara Peris

  6. Department of Psychiatry, University of Connecticut School of Medicine, 65 Kane Street, Room 3788, West Hartford, CT, 06119, USA

    Golda S. Ginsburg

Authors
  1. Asima Zehgeer
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  2. Golda S. Ginsburg
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  3. Phyllis Lee
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  4. Boris Birmaher
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  5. John Walkup
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  6. Philip C. Kendall
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  7. Dara Sakolsky
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  8. Tara Peris
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Corresponding author

Correspondence to Golda S. Ginsburg.

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Conflict of interest

None of the authors have potential conflicts of interest to report.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. This article does not contain any studies with animals performed by any of the authors.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Zehgeer, A., Ginsburg, G.S., Lee, P. et al. Pharmacotherapy Adherence for Pediatric Anxiety Disorders: Predictors and Relation to Child Outcomes. Child Youth Care Forum 47, 633–644 (2018). https://doi.org/10.1007/s10566-018-9459-9

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  • DOI: https://doi.org/10.1007/s10566-018-9459-9

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