Michele H. Maddux, PhD
Director, Gastroenterology Medical Transition; Child Psychologist; Associate Professor of Pediatrics, University of Missouri-Kansas City School of MedicineFull Biography
Michele Maddux, PhD, Clinical Psychologist, Gastroenterology, was recently awarded a 2-year, $100,000 NASPGHAN Foundation Mid-Level Career Development Award from the NASPGHAN (North American Society of Pediatric Gastroenterology, Hepatology, And Nutrition) Foundation.
Dr. Maddux’s study, “Adherence Monitoring and Intervention in Pediatric Healthcare: Development and Implementation of a Clinical Decision Support System,” looks to use health information technology to help in the management of poor medication adherence (taking medications as prescribed) in children and adolescents with gastrointestinal (GI) disorders.
As Dr. Maddux explains, rates of youth with pediatric GI disorders who don’t take their medications as prescribed are linked to treatment failure, disease progression, impaired quality of life, and a significant increase in healthcare costs, and adolescents are at particular risk for medication adherence.
“My preliminary qualitative work suggests that few pediatric GI providers routinely assess adherence or discuss evidence-based adherence-promoting interventions with patients, most rate their level of adherence monitoring and intervention as fair to poor, and while most perceive adherence monitoring to be very important in clinical practice, only a fraction say they’re able to significantly change patient adherence,” she said. “Primary barriers to doing adherence monitoring and intervention as a routine part of standard clinical care include lack of clinic time, lack of manpower and resources, and lack of staff with skills/expertise to target adherence and provide intervention. This shows there is a critical need to embed provider use of evidence-based adherence intervention within the clinical workflow of pediatric GI providers.”
Dr. Maddux and her team will test the preliminary effectiveness of an electronic health record (EHR)-based clinical decision support (CDS) tool to aid in the management of poor medication adherence among young patients with GI disorders. This CDS tool, called the “Adherence Action Plan (A2P),” enables patients to provide information about their unique barriers to medication adherence within the EHR. This patient information is then used to trigger patient-centered EHR-based decision support that clinicians can use at the point of care to optimize adherence.
“By providing clinicians with an automated clinical decision-making support tool whereby evidence-based adherence-focused interventions are efficiently matched to unique patient medication barriers, the A2P fits into a longer-term plan to comprehensively address the critical gap in routine adherence screening, monitoring, and intervention,” said Dr. Maddux.
This NASPGHAN Foundation grant is for NASPGHAN members pursuing research in pediatric gastroenterology, hepatology and nutrition. This award is to foster either a new area of enquiry or to provide pilot data in an ongoing area of research with substantial potential for new funding.
Mark Connelly, PhD, Children’s Mercy Kansas City, Jeannie Huang, MD, MPH, Rady Children’s Hospital San Diego, and Kevin Hommel, PhD, Cincinnati Children’s Hospital Medical Center are co-investigators on the study.