Improving adherence to treatment in child health

Adherence is a common, important and under-recognised problem in paediatric practice, especially around chronic disease management. Poor adherence, usually either for some of the time or for some elements of treatment, is a complex phenomenon with sociological, psychological and medical roots, which requires a patient and skillful approach.This paper presents the scope and degree of the problem, before explaining some of the ways in which patients arrive at a position of poor adherence, before presenting a practical approach to tackling poor adherence in paediatric clinics, incorporating ideas from motivational interviewing.