Adherence

Support from close friends can be an important resource when adhering to treatment regimes. Since non-adherence contributes to increased morbidity, health professionals need to pay close attention to this area. Asking a young person about their friends is not only a good way to build rapport and demonstrate an interest in them as a young person and not simply a patient, but also it is a useful method of identifying those who are socially isolated as well as determining potential health risk behaviors. Members of particular peer groups tend to be similar in health risk behaviors, therefore asking about friends may be revealing about the young person themselves (13). Young people with chronic illness sometimes feel "different" and therefore in order to "fit in" may be discordant with medical treatment or ignore lifestyle advice regarding diet, exercise, alcohol, drugs, etc.

Adherence to therapy and disease management may prove challenging to some young people during this stage of development (14). The challenge for health care professionals is to engage young people as active participants in their disease management and in informed decision making regarding their treatment. Encouraging young people to bring a friend along to clinic may prove useful in increasing the friend's knowledge of the condition, as well as increasing awareness of the constraints and challenges it poses for the young person. Subsequently this may result in increased practical support with health related behaviors. Integral to success and quality in this area of health care is the design of holistic, developmentally appropriate and innovative interventions which best meet the psychosocial needs of young people and facilitate their evolving independence. Adherence is discussed further in Chapter 5.

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