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7. Relapse Prevention
Having children do anything everyday can be a challenge. The child may be sick or just not want to swallow the medicine. Here are some strategies that are useful in minimizing the possibility of non-adherence.
Consistency is key. Ideally, make pill-taking part of the everyday routine (i.e., a habit like brushing your teeth or washing your face). Within reason take the pills at the same time and in the same place everyday.
Do not bargain or bribe the child to take medication. Bargains or bribes will likely cause the child to take medicine to earn a reward, rather than because it is a habit, an expected part of growing up, or good for him.
Avoid power battles with medications. Do not threaten the child with punishment for not taking medication. Do not attempt to "trick" the child into taking medication (e.g., do not mix in foods, etc.).
Once in a while a child who can take medications may refuse. If the child is allowed to not take the medications in that instance, the likelihood of future non-adherence increases. Further, depending on the medications, non-adherence for even one day can have a huge impact on the effectiveness of treatment. When the child refuses to take the medication, the world should stop for this child until he/she takes the medication. Specifically, the child should not move on to other activities and should have no diversions until the medication is taken. At times, this may be very inconvenient for the parent. However, if parents do this each time there is a refusal, the likelihood of future refusals greatly decreases. If non-adherence lasts for more than one dosage of medication, consultation with the medical team and referral to a behaviorally-oriented psychologist is recommended.
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