Emotional difficulties or psychopathology displayed by the patients (e.g., depression) or dysfunction in the family (e.g., substance abuse, coercive patterns of interaction) should be identified and specialized care (e.g., psychotherapy or psycho-pharmacological treatment) should be suggested and arranged (69).
Evidence also showed that increased parental supervision is quite effective in the improvement of general adherence (1). Yet, the aim is that adolescents learn to care for themselves (51). Adolescents need frequent support, encouragement, and positive feedback when striving to manage their chronic illness. Health-care providers should involve the family or significant others in care whenever possible and offer them tools to support and reward adherence (1). In addition, adolescents should be encouraged to participate actively in planning and decision-making processes (59). Peer groups may also be valuable sources of emotional support. In addition, support groups for adolescent patients may allow patients to share common problems and to discuss methods of coping and problem solving from peers experiencing the same struggles with medication adherence.
Modern communication tools may help to maintain a level of support between the patient, the parents, and the health care team. Patients can be empowered by e-mail interactions with the health care provider, or phone calls. Clinicians can also provide information about accurate and useful health websites (51).
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