Promoting Medication Adherence and Regimen Responsibility in Two Adolescents on Hemodialysis for End-Stage Renal Disease: A Case Study

Medication adherence and regimen responsibility (RR) have important implications for adolescents with hemodialysis-dependent end-stage renal disease (ESRD). This case study assesses the preliminary efficacy of a cognitive-behavioral intervention to promote medication adherence and RR in two African American adolescents. Two patients and their mothers participated. Intervention modules addressed adherence barriers. Using a case-series design, weekly parent– adolescent reports of medication adherence and RR were collected. The female participant’s selective nonadherence improved during treatment. Mother and daughter were high in RR throughout the study. The male participant’s adherence initially decreased following his mother’s reduced involvement in treatment. His adherence improved by the end of treatment, and coincided with his mother’s reassumption of RR. Improvements were maintained through follow-up for both patients. This case study provides preliminary support for using a cognitive-behavioral protocol to improve medication adherence in adolescents with hemodialysis-dependent ESRD.