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Helping Kids Take Their Medicines

Medication Adherence Tips for Children Taking HIV Medications

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Updated January 07, 2009

Any adult who has been prescribed HIV medications knows just how difficult adhering to those drugs can be. Between the number of pills, nausea, diarrhea, and the long-term side effects, HIV medication adherence can be tough. So it's no surprise when I hear what a hard time parents have getting their child to take their medications. Luckily, there are ways to help your kids take their HIV medications each and everyday.

How Adherent is Adherent?

So when we talk about adherence, what is considered adherent? How many doses can your child miss and still be considered adherent? How many missed doses does it take before your kid's medications no longer work? Studies of adherence in adults find that 95% adherence is necessary to realize the full effects of a medication regimen. In other words, your child must take 95 of his next 100 doses to be considered adherent and to have a drug combination that works. Any more than that and the potential for viral resistance and HIV mutation increases. But I realize that getting your child to take 95 of their next 100 doses is easier said than done. In fact, studies of adherence in children show that only 25% to 50% of kids are adherent to their regimen. In other words, almost half of all kids are not 95% adherent. So if you are having trouble getting your child to take his medication, you are not alone.

What are the Barriers to Adherence in HIV Positive Kids?

Experts know how difficult it can be for adults to take their HIV regimens. The issues your kids are having comes as no surprise. Some of those adherence issues in children include:
  • Medication formulations can be difficult for your kids to tolerate. Large pills, bad-tasting liquids, and dry, hard to dissolve powders make swallowing medications a challenge.

  • Unpleasant side effects, especially those that are short term, may make children feel sick after taking their dose of meds. This can make it difficult to convince them that the medicines are good and will help fight their illness.

  • Depending on his age, it's a lot to expect your child to understand their HIV disease. In fact, your child may not realize that he has an illness that requires medication. Unfortunately, the less your child understands about HIV, the harder it will be to get him to take medications.

  • Times are tough, especially when a family member has an illness that requires costly medications each month. Making ends meet, working to make a living and caring for your child are difficult tasks to say the least. Financial pressures make adherence a challenge for the entire family.

    How Can You Help Your Kids Take Their Medications?

    There are ways to improve your child's medication adherence. Here are a few.
    • Attitude is Everything - Your attitude with regard to the benefit of HIV medications does affect your child's willingness to take them. If you don't believe in the benefit or effectiveness of a drug regimen, it will be difficult to convince your son or daughter that the drugs are necessary. A positive and supportive attitude toward the medication regimens will make adherence by your child much less difficult.

    • Simpler is Better - As is the case with adults, using the simplest regimen that will prove effective is key to better adherence. Fewer pills fewer times each day will improve adherence in adults and kids alike. Talk to your child's doctor to make sure he is keeping the regimen as simple as possible.

    • "A Spoonful of Sugar" - Like we discussed earlier, the formulation of certain drugs can make or break adherence. A simple thing like improving or masking the taste can make a huge difference. Mix liquid medicines in juice or a beverage that will mask the bad taste, making sure not to mix it with so much liquid your child can't drink the entire amount. Tablets can be crushed and added to foods like ice cream or pudding. The meds will taste better and your child will not have to swallow such a large pill. Just make sure you check with your doctor or pharmacist before crushing any medicines. Some pills should not be crushed or broken and capsules should never be opened or pulled apart.

    • Ask Your Nurse or Doctor For Help - Your nurse and doctor want your child to succeed. Use their expertise by calling when your child resists or has an issue taking his medicine. Ask for a contact number of your doctor's office that can be used if there are problems giving your child their medications.

    • Learn All You Can - Make certain you understand the medications prescribed for your child before leaving the office. Medication fact sheets are available, such as those here at About.com. Ask questions of your healthcare team if you find you don't understand the meds thoroughly. You have to understand before you can help your child understand.

    • Allow Your Child to Participate - When old enough, kids should be encouraged to participate in the medication process. Let them take their meds under strict supervision. As they grow up, allow them to do more independently, taking a more active role in their meds each day.

    • Listen to Your Child - Your son or daughter will let you know when there are problems. Be supportive and listen to their issues. Expect them to be frustrated at times. But by actively listening to your child, he will feel empowered some control over his illness and treatment.

    As is the case in adults, medicating your child is going to be difficult at times. And at times adherence is going to seem impossible. But if you and your child understand the medications and work together with your provider, medication adherence will come much easier and at a much younger age.

    Sources:

    Brackis-Cott, E, et al; Pediatric HIV Medication Adherence: The Views of Medical Providers from Two Primary Care Programs; Journal of Pediatric Health Care; 2003; 17(5): 252-260.

    Cona, K.; Parental Beliefs About Medications and Medication Adherence Among Urban Children with Asthma; Ambulatory Pediatrics, 2003; 5(5): 306-310.

    Gardner, P. and Dvorkin, L.; Promoting Medication Adherence in Children; American Family Physician; 2006; 74(5):793-798.

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