Promoting adherence and increasing life Span

For patients with cystic fibrosis, adherence with lifelong treatment may be challenging, particularly as individuals enter into emerging adulthood (age 19-25 years). This article explores the various factors that are known to impact adherence, with a focus on the contribution of emerging adulthood on the major nonadherence typologies (erratic adherence, unwitting nonadherence, and intelligent nonadherence). Social support is considered critical to adherence, with practical support (eg, instrumental support, assistance, reminders, and organization), emotional support (eg, nurturance and empathy), and having a cohesive family all highly associated with treatment compliance. Patients who fall into one of the nonadherence typologies have a general higher risk of nonadherence as they enter adulthood because a major aspect of social support (parental involvement) begins to diminish. For example, patients with erratic adherence (understand andagree with therapy but have difficulty consistently maintaining regimens) may find it particularly difficult to adhere to regimens during emerging adulthood, in the face of variable college and sleeping schedules, work schedules, travel, alcohol consumption, and impromptu social opportunities. Also discussed in this article are reliable ways of measuring adherence (medication refill history and patient reports of nonadherence) and empirically supported adherence promotion techniques.