Adherence and Self-management

As adolescents and young adults (AYA) with a range of diagnoses transition from pediatric to adult-focused healthcare systems, developing strategies to maintain health outcomes during this period is critical. A key driver for maintaining optimal outcomes is adherence to recommended care therapies and condition-specific management plans. However, for AYA, particularly those with complex chronic health conditions, adherence to a daily regimen is a challenge. Therapeutic regimens are often complex, multifaceted, and time-consuming. Additionally, normal adolescent development, including a desire for independence from caregivers, can hinder appropriate adherence behaviors and disease self-management. Therefore, improving adherence is a key part of transitional care. This chapter reviews the clinical approach to adherence for AYA with chronic health conditions, including the recognition of distinct patterns of adherence behaviors, outlines barriers to optimal adherence, and suggests strategies to improve adherence in this high-risk population.