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Number of families not sticking to treatment plans ‘alarming’

When approaching a child’s long-term illness, an alarming number of families are not adhering to treatment plans, Queensland researchers have said. And some are contributing to ongoing difficulties by being too over-protective.

Associate professor Alina Morawska, from the University of Queensland, said rates of treatment adherence for conditions including asthma and eczema are stubbornly low, at between 40 and 60 per cent.

Morawska said it was evident that the issue of adherence seemed to be linked to the child’s behaviour and routines that were in place, but she added that when children are unwell, parents can also become over-protective in their parenting style.

“The key for the parents who took part in our study is when they realised that a parenting style with very few limits or rules to guide children’s behaviour, or being too over-protective, actually contributed to ongoing difficulties with their child over the long term.”

Morawska said this lightbulb moment happened often during the Positive Parenting Program (Triple P) sessions that the team ran as part of a three-year study.

The research established that a brief version of the Triple P program has the potential to improve parenting skills, which could lead to better child behaviour and health-related outcomes.

“Helping families of children with chronic health conditions to follow medical advice and stick with a treatment regime would have an impact on the costs of supplying medical services, such as unplanned hospital admissions, as well as improving the lives of these children and their families,” Morawska said.

Now, the research group wants to demonstrate that a light-touch behavioural parenting intervention could have an impact on children’s physical symptoms.

“We’ve demonstrated through the use of parent report diaries, for example, that their children’s symptoms improved, particularly with more severe disease, but what we want to do is get objective measures of both the severity of the disease as well as adherence.”

She said electronic monitoring technology attached to children’s medication devices could be used to objectively measure treatment adherence.

“Parents of children with asthma and eczema are certainly keen to participate in this kind of research, which gives us a sense of how much this type of help is needed,” Morawska said. “These parents are often under a lot of stress, which makes the job of sticking to medication schedules difficult.

“It makes sense that a parenting intervention can help but we need to show actual treatment outcomes before we can make the case for an intervention such as this to be made more widely available.”

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