Assessment of barriers to medication compliance in the HIV pediatric population: A clinic review of cases

Principal Investigator: Keith Slifer

Children w/ chronic medical conditions & their families face many challenges in attempting to adhere to complex medical regimens. These challenges are particularly striking for children w/ HIV, for whom compliance w/ a complex medication regimen must approach 95% in order to be effective, & for whom results of medication noncompliance can be devastating. The import-ance of identifying specific factors contributing to less than medically indicated compliance is clear for this population. In the medical setting, medication “noncompliance” is often conceptual-lized broadly. Applied Behavior Analysis methods can assist in identifying specific barriers to compliance & in operationally defining appropriate targets for clinical intervention. An anony-mous chart review will be performed using deidentified data. Deidentified data will be presented from 32 inpatient cases of pediatric HIV referred for behavioral assessment & treatment of medication noncompliance. Functional assessment & task analysis approaches will be utilized to identify & operationalize barriers for each case. Data will be presented that summarize barriers, and the percentage of cases for which each specific barrier was identified will be summarized. Results will be discussed in regard to the application of behavior analysis methods to assist medical staff in optimizing adherence to medical regimens.