2000-2020 NHIS Studies: Factors affecting medication adherence rate in the pediatric population with medical complexity

Janice Tong, Savion Carswell, Erica Wong, Xinyu Wang, Yujin Kim

Research output: Contribution to conferencePresentation



Children with medical complexity belong to a vulnerable patient population group that is defined by the interplay of chronic health conditions, high healthcare utilization, and severe limitations in cognitive and/or physical functioning. Members of this patient population often require a complex management and/or treatment regimen with the use of more than one medication. Pediatric nonadherence in medication can lead to increases in microbial resistance, adverse drug reactions, morbidity, and mortality. The consequences of this medication nonadherence may also cause slower recovery times, increased number of emergency department visits, and hospitalizations, which subsequently substantiates higher medical costs for families along with the healthcare system. General factors for pediatric medical adherence include age, culture, family structure, socioeconomic status, schedule of medication therapy, and taste/formulation of therapy. Continual studies on these medical adherence factors are of the utmost importance to mitigate nonadherence improving quality of life and reducing medical costs. This study examines the variables and confounding factors that may be responsible for the prevalence of nonadherence in this patient population.


Twelve primary articles using data collected through the National Health Interview Survey (NHIS) – focused on medication adherence secondary to medication therapy management (MTM) in the pediatric population across various chronic disease states –were examined and analyzed to collect the variables and factors of interest. Each article in the review was chosen to analyze a national representation of U.S. children between the years 2000-2020. The age perimeter was between ages zero (infants) to eighteen.


Among the fifteen NHIS papers measuring medication adherence outcomes, three addressed financial and family disparities, three focused on the racial disparities’ association, and the remaining nine papers address other confounding factors (including but not limited to geographic location, patient education, and healthcare access). Results from the analysis confirmed the influence that racial/ethnic and/or socioeconomic disparities have on the medication adherence rate of the US pediatric population with medical complexity.

Conclusion The medication adherence rate is affected by racial and ethnic disparities, financial hardships, socioeconomic status, family background education, poverty status, children’s health status, quality of patient education, and religious beliefs. This calls for more public health policies to alleviate the financial burden of medication costs, as well as efforts to improve medication education for the caregivers of children with medical complexity population in the U.S. The data-collecting phase of this research reveals the scarcity of studies on this topic – as reflected in the small number of articles found and reviewed. For a better understanding of the medication adherence rate among the medically complex pediatric population of the U.S., further research on this topic should be conducted.

Original languageAmerican English
StatePublished - May 11 2023


  • Medication adherence
  • pediatrics
  • children
  • medical complexity
  • NHIS


  • Medicine and Health Sciences

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