• Rachel Neff Greenley, Jennifer Hauser Kunz, Vincent Biank, Alfonso Martinez, Adrian Miranda, Joshua Noe, Grzegorz Telega, Neelesh Ajit Tipnis, Steven Werlin, and Michael C Stephens.
• Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, Illinois 60064, USA. rachel.greenley@rosalindfranklin.edu
• Inflamm. Bowel Dis. 2012 Jul 1;18(7):1254-9.

BackgroundTo examine the validity of patient self-report of thiopurine adherence in pediatric inflammatory bowel disease (IBD) against an objective electronic monitoring adherence measure, and to investigate the role of youth and maternal involvement in remembering to take daily medications as predictors of medication adherence.MethodsFifty-one youths with IBD, ages 11-18 years, participated. Youths completed questionnaire assessments of their own and their maternal caregiver's involvement in remembering to take daily medications at baseline, completed monthly interviews assessing thiopurine adherence over the past week for a period of 6 months, and utilized a Medication Events Monitoring System (MEMS) electronic monitor for their thiopurine medication for 6 months. Participants were grouped into adherent (at least 80% of doses taken based on objective MEMS caps) or nonadherent for analyses.ResultsYouths who were nonadherent based on electronic monitoring overestimated their adherence by 23%, whereas adherent youths overestimated their adherence by only 2%, and as such patient self-report offered little utility in identifying youths who were nonadherent. Youths who reported high levels of involvement in remembering to take their medications were nearly eight times less likely to be nonadherent.ConclusionsThe current findings provide evidence that clinicians who work with children and adolescents with IBD may benefit from modifying their approach to nonadherence screening. Asking about youth involvement in remembering daily medications may be more informative than asking them to recall their medication-taking behavior over the last week in identifying those at highest risk for nonadherence.Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

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