Pharmacy U

5 tips to help caregivers administer meds to kids


5. Encourage adherence

Medication adherence is more challenging in adolescents compared to children or adults.(17) Potential barriers to medication adherence include stigma from peers, parental conflict, lack of healthcare provider support, a desire to be “normal,” the need for freedom or control, adverse effects, stress, forgetfulness, medication regimen complexity or cost.(17) Educational interventions alone are unlikely to improve adherence in children and adolescents.(18) Behavioural interventions, such as goal setting, rewards, contracting, and linking medication administration to routines, either alone or in combination with education, may improve adherence.(18) A comprehensive approach with regular follow-up, establishing a therapeutic partnership with the family, identifying barriers, and teaching self-management can improve adherence in children and adolescents with chronic illnesses.(19) Choosing once- or twice-daily medication regimens may also help improve adherence.(12)

Jennifer Kendrick ( is a clinical pharmacist at the Children’s and Women’s Health Centre of BC in Vancouver, and a clinical instructor at the Faculty of Pharmaceutical Sciences, University of British Columbia.


This article originally appeared in Pharmacy Practice+Business.

1. Boztepe H, Ozdemir H, Karababa C, et al. Administration of oral medication by parents at home. J Clin Nursing 2016;25:3345-53.
2. Bryson SP. Patient-centred, administration friendly medicines for children – evaluation of children’s preferences and how they impact medication adherence. Int J Pharmaceutics 2014;469:257-9.
3. Venables R, Batchelor H, Stirling H, et al. Barriers to administering non-oral formulations in a paediatric population: a semi-structured interview study. Int J Pharmaceutics 2016;497:12-7.
4. Grover C, Armour C, Van Asperen PP, et al. Medication use in children with asthma: not a child size problem. J Asthma 2011;48:1085-103.
5. Czyzewski DI, Runyan RD, Lopez MA, et al. Teaching and maintaining pill-swallowing in HIV-infected children. AIDS Read 2000;10:88-94.
6. Kaplan BJ, Steiger RA, Pope J, et al. Successful treatment of pill-swallowing difficulties with head posture practice. Paediatr Child Health 2010;15:e1-5.
7. Alberta Children’s Hospital Research Institute. Better than a spoonful of sugar – how to swallow pills. (accessed March 17, 2017).
8. Cates CJ, Welsh EJ, Rowe BH. Holding chambers (spacers) versus nebulisers for beta-agonist treatment of acute asthma. Cochrane Database Syst Rev 2013; 9:CD000052.
9. BC Centre for Disease Control. Communicable Disease Control. Immunization Program. Section IV – Administration of biological products. January 2016. (accessed April 5, 2017).
10. Beirne PV. Needle size for vaccination procedures in children and adolescents. Cochrane Database Syst Rev 2015;6:CD010720.
11. Forum for Injection Technique (FIT) Canada. Recommendations for best practice in injection technique, March 2012. (accessed April 5, 2017).
12. Gardiner P, Dvorkin L. Promoting medication adherence in children. Am Fam Physician 2006;74:793-8.
13. Seattle Children’s Hospital. Helping your child take medicine. (accessed March 17, 2017).
14. Bush PJ, Ozias JM, Walson PD, et al. Ten guiding principles for teaching children and adolescents about medicines. Clin Ther 1999;21:1280-4.
15. Hameen-Anttila K, Juvonen M, Ahonen R, et al. How well can children understand medicine related topics? Patient Educ Couns 2006;60:171-8.
16. Hameen-Anttila, Bush PJ. Healthy children’s perceptions of medicines: a review. Res Social Adm Pharm 2008;4:98-114.
17. Hanghoj S, Boisen KA. Self-reported barriers to medication adherence among chronically ill adolescents: a systematic review. J Adolescent Health 2014;54:121-38.
18. Dean AJ, Walters J, Hall A. A systematic review of interventions to enhance medication adherence in children and adolescents with chronic illness. Arch Dis Child 2010;95:717-23.
19. Brand PLP, Klok T, Kaptein AA. Using communication skills to improve adherence in children with chronic disease: the adherence equation. Paediatr Respir Rev 2013;14:219-23.