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| Medical and Service Setting Issues |
| Monday, May 31, 2010 |
| 3:00 PM–4:20 PM |
| Crockett A/B (Grand Hyatt) |
| Area: CBM |
| Chair: Annette Griffith (University of Nebraska-Lincoln) |
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| Use of Behavioral Data in the Management of Psychotropic Medications for Youth in Residential Treatment |
| Domain: Service Delivery |
| ANNETTE GRIFFITH (University of Nebraska-Lincoln), Douglas F. Spellman (Boys Town Outpatient Behavioral Pediatric and Family Services), Jonathan C. Huefner (Boys Town Outpatient Behavioral Pediatric and Family Services), Laurel Leslie (Tufts Medical Center), Michael H. Epstein (University of Nebraska-Lincoln), Nirbhay N. Singh (ONE Research Institute) |
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| Abstract: The use of psychotropic medications for youth is controversial. This controversy is particularly relevant for youth who are in residential treatment, many of whom enter care highly medicated. As many as 80% have prescriptions for at least one psychotropic medication and as many as 55% have prescriptions for three or more. Many of these medications come with a heavy health burden and adequate research examining safety and efficacy has not been done with youth. As such, physicians who work with youth in residential settings have the important task of assessing existing psychotropic prescriptions at the time of entry for safety and suitability. Daily behavioral data collected within residential treatment programs can be a key source of information to help physicians in this decision-making process. Specifically, it can provide physicians with objective information about efficacy and the effects of medication changes on behavior. This paper will present a rationale for the use of behavioral data as part of the psychotropic medication management process and will provide information on how data-based decisions can be made. A case study will be presented to demonstrate how behavioral data has been used successfully to assist in the medication management process within a residential setting. |
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| Behavioral Management of Pediatric Medical Regimens: Translating Theory Into Practice and Addressing Nonadherence |
| Domain: Service Delivery |
| LISA M. TODD (Wayne State University School of Medicine) |
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| Abstract: Nonadherence to medical regimens can result in problems such as the spread of disease, negative health outcomes, increased medical utilization, and decreased quality of life. Proper adherence to medical regimens can be difficult and families may struggle to overcome complex barriers even when they have the knowledge and skills to be successful. Factors that contribute to nonadherence may not be disclosed to practitioners or well understood by families. Therefore, these factors may not be addressed sufficiently or in a timely manner. Motivations for nondisclosure may include embarrassment, avoidance, and interpersonal skills deficits. Other factors may include disorganization and practitioner variables. Theoretical perspectives that are particularly relevant to understanding and addressing nonadherence include applied behavior analysis, ecological systems, and the health beliefs model. In this presentation, diabetes mellitus will be used as an exemplar to examine common barriers to adherence and disclosure. Behavioral interventions for family and community systems will also be discussed. |
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| An Analysis of Potential Predictors of Caregiver Compliance |
| Domain: Applied Behavior Analysis |
| ANJALI VAN DRIE (Behavior Analysis and Therapy, Inc.), Jill Emmick (Behavior Analysis and Therapy, Inc.), Ryan Mathew Curran (Behavior Analysis, Inc.), David Garcia (Behavior Analysis, Inc.), Stephen P. Starin (Behavior Analysis, Inc.) |
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| Abstract: Behavior analysts have been successful at providing data based interventions across a variety of populations. Regardless of the population being served, caregiver compliance and treatment adherence remains a challenge for clinicians. For any behavior plan to be successful, it requires consistent and accurate implementation. Several studies have examined possible contingencies that may be responsible for the lack of caregiver compliance; however, there is little research on potential variables that may help to predict caregiver compliance before treatment commences. A preliminary analysis of variables that occur prior to direct services being implemented indicated that families who promptly responded to initial contact and maintained the initial scheduled appointment demonstrate greater caregiver compliance and treatment adherence throughout the length of services. Further analyses will be conducted to assess the impact that these variables have on caregiver compliance with treatment procedures. Moreover, the correlation observed between caregiver compliance and behavior change in the target clients will be discussed. |
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