The Impact of COVID-19 on Pediatric Adherence and Self-Management

Jill M. Plevinsky, PHD; Melissa A. Young, PSYD; Julia K. Carmody, PHD; Lindsay K. Durkin, MS; Kaitlyn L. Gamwell, PHD; Kimberly L. Klages, PHD; Shweta Ghosh, PHD; Kevin A. Hommel, PHD


J Pediatr Psychol. 2020;45(9):977-982. 

In This Article

Summary and Future Directions

Although the circumstances surrounding the COVID-19 pandemic and its broad impact (both positive and negative) across individual, family, community, and healthcare systems factors impact pediatric adherence and self-management, pediatric psychologists have the expertise to recognize, assess, and address these challenges to promote health outcomes. Future research ought to utilize a mixed-methods approach to examine how the COVID-19 pandemic has affected pediatric adherence and self-management in order to best inform clinical care and healthcare policy development. Research is especially needed to examine the extent to which the pandemic has exacerbated pre-existing pediatric healthcare disparities that affect these outcomes and health outcomes broadly. Digital tools, such as electronic adherence monitors, adherence-promotion mobile apps, and telehealth can be used to facilitate these efforts (Stiles-Shields et al., 2020).

Youth with chronic medical conditions and their families are resilient, and with support from their medical teams and behavioral health providers, can achieve optimal adherence and self-management despite the challenges brought about by the COVID-19 pandemic. However, we must acknowledge the potential enduring adverse effects of the pandemic on pediatric adherence and self-management. Long-standing adverse effects may come as a result of unemployment and associated loss of family healthcare benefits, as well as youth and caregiver mental health sequelae due to prolonged social isolation or other pandemic-induced stressors. Families may also receive reduced support from illness-specific non-profit foundations due to financial strain. Furthermore, youth with comorbid learning disabilities may receive reduced special education support from schools in developing skills necessary for optimal adherence and self-management (e.g., problem-solving).

As the current public health situation evolves, pediatric providers will need to continue to support these youth and their families in being able to adapt to uncertainties, establish new routines, access healthcare (e.g., medications, medical interventions, healthcare services), and use new technologies (e.g., telemedicine, adherence apps) to promote disease management and reduce poor health outcomes.