The Overestimation of Adherence to Pediatric Medical Regimens

We evaluated the accuracy of primary health care providers' predictions of parents' adherence to their children's short-term antibiotic regimen and a scheduled follow-up appointment. Adherence predictions were compared with objective measures of the parents' adherence. Providers were poor predictors of nonadherence, greatly overestimating the percentage of parents who would be adherent. Nonadherence is typically addressed by applying adherence improvement strategies to all patients. Recent pediatric research, however, suggests that applying contingency-based interventions for adherent patients can result in later nonadherence if the strategies are withdrawn. Inaccurate predictions of adherence will result in many nonadherent patients not receiving a needed intervention. The results indicate the need for strong behavioral predictors that result in more accurate identification of patient nonadherence to guide further applications of adherence improvement strategies.