Preliminary quantitative investigation of predictors of treatment non-adherence in pediatric transplantation: a brief report.

The examination of predictors of non-adherence in transplantation populations offers the potential to identify high-risk individuals and concomitantly generate effective adherence-promoting interventions. The present paper aggregated quantitative estimates of various correlates of treatment adherence in studies of pediatric transplantation. Seventeen studies and three classes of predictors of non-adherence, including demographic, psychosocial, and treatment-related predictors, were included in the current analyses. The weighted means effect sizes for the demographic factors were in the small to medium range (female gender mean d = 0.35, 95% CI = 0.32-0.38, n = 8; mean age d = 0.55, 95% CI = 0.52-0.58, n = 7), suggesting that older youth and males tended to display more non-adherence behaviors than younger youth and females, respectively. Several psychosocial factors exhibited large to very large relationships with non-adherence, in particular comorbid psychiatric conditions (mean d = 1.04, 95% CI = 0.66-1.42, n = 3) and child self-responsibility for medication (mean d = 0.88, 95% CI = 0.53-1.23, n = 3). Finally, prior treatment/grafts (mean d = 0.17, 95% CI = -0.15-0.49, n = 3) and donor source (mean d = 0.33, 95% CI = -0.10-0.76, n = 4) exhibited small, non-significant relationships with non-adherence. Limitations of the study are discussed as are future directions for research.