Demographic, psychosocial, and biomedical predictors of caregiver-reports of child adherence to psychotropic medication regimens

Psychological disorders diagnosed in childhood are increasingly being treated using psychotropic medications. While many psychopharmacological treatments for youth have shown promise in clinical trials, the real-world effectiveness of psychotropic medications has been curtailed by high rates of youth non-adherence. Subsequently, some investigators have examined demographic, psychosocial, and biomedical variables that influence adherence to psychopharmacological treatments. However, the extant literature is characterized by inconsistent findings and emphasizes the psychopharmacological treatment of attention problems and adolescents. The current study explored caregivers' reports of their non-adolescent children's use of and/or adherence to any psychotropic medication. All participants completed a questionnaire assessing demographic and psychosocial variables; caregivers whose children were using a psychotropic medication also completed a second questionnaire measuring adherence and additional psychosocial and biomedical variables. Data analyses explored differences between children who did and did not use psychotropic medications, as well as which factors significantly predicted caregiver-reported adherence. Child use of psychopharmacological treatments was significantly predicted by older child age, receipt of public insurance, and more positive caregiver attitudes regarding the effectiveness of psychotropic medications for youth. Most caregivers reported that their children were highly adherent, and caregiver race-ethnicity and child difficulty with swallowing medications significantly predicted adherence. The results have implications for understanding which demographic, psychosocial, and biomedical factors are associated with satisfactory adherence among children using psychotropic medications.