As children mature, they may become increasingly reluctant to share health concerns with Mom and Dad; partly out of modesty and partly to assert their independence. That is why teenagers need a pediatrician in whom they can confide.
Now is also the time for teens to learn to become savvy medical consumers. They should be encouraged to schedule their own doctors’ visits and to ask questions anytime they don’t understand something the pediatrician has said. Where health matters are concerned, there is no such thing as a “dumb” question. Every patient, regardless of age, is entitled to clear explanations of her condition and the recommended treatment plan.
Above all, adolescents need to be coached on the importance of taking medications as directed. If there is one source of frustration for pediatricians, it’s their young patients’ lack of compliance (although as Dr. Kulig, M.D., M.P.H. points out, “compliance among adults isn’t much better”). In one study of children suffering from throat infections, more than 80 percent failed to finish their antibiotics, which had been prescribed for ten days. Presumably, most of them started to feel better after several days and figured they could stop taking the medicine. But we know that the entire course of antibiotics must be completed in order to fully eradicate the infection. Otherwise, the bacteria regain a foothold, stronger than ever, and the symptoms return.
Teens may also resist following doctors’ orders as a display of rebellion. Dr. Kulig advises that parents monitor their youngster’s compliance, but without assuming the mantle of responsibility. The most successful strategy, he’s found, “is to solicit kids’ input about how to best stick to medication schedules, rather than demanding, ‘You must take this medicine.’ ” He offers several tips:
To eliminate confusion, post a calendar on the refrigerator and place a check mark in the appropriate box each time the medication is taken. Or purchase an inexpensive plastic pill holder, in which oral drugs are stored according to the day of the week and daily Sunday through Saturday, and dose (morning, afternoon, evening).
Have the teenager take the medicine at the same time as one of his daily rituals, like brushing his teeth. “It becomes a cue for compliance,” explains Dr. Kulig. “When they brush their teeth in the morning and at night, they remember they need to take their medicine.”
Practice positive reinforcement. Praise your adolescent each time he adheres to the medication schedule.
Remind young men and women why a medication has been prescribed. “Adolescents should understand the purpose of the therapy as well as the potential consequences of noncompliance,” says Dr. Kulig. “They should also be aware of how long they may have to be on the medication before they can expect to see optimum results.
“For instance, some acne medications can take upward of twelve weeks to start working. If a teen gets discouraged and discontinues the drug, obviously the acne won’t get better. Likewise, if he grows impatient and overuses it, he may irritate and dry out the skin.”
Another reason for supervising young people’s consumption of medicines is that some drugs have the potential for abuse, whether they’re prescribed or over-the-counter. “Tylenol is a good example,” says Dr. Kulig. “Too high a dose can basically destroy the liver.” Most overdoses of nonprescription agents are taken intentionally, as part of suicide attempts, but excessive amounts can be ingested accidentally. “Teenagers,” he stresses, “are not aware of how toxic these products can be.”
As a precaution, it’s wise to never leave a family member’s medication out where it can fall into the hands of an inquisitive child or a teenage pal looking for a “legal” high. According to Dr. Timothy Wilens, a pediatric psychiatrist at Massachusetts General Hospital, also in Boston: “Most prescription drugs are abused not by the kids for whom they’re prescribed, but by other children. All containers should be stored away, with each dose administered individually.”
Questions to Ask the Pediatrician Before a Teenager Starts Any New Medication
- What are the medication’s generic name and trade name?
- What is the purpose of using this medication?
- How often should the medication be taken, and at what time(s) of day?
- What is the dosage?
- Is it necessary to swallow this medication with food or milk?
- If your youngster has difficulty ingesting pills, ask if the medication can be crushed, or if it comes in the form of a liquid, skin patch, rectal suppository, inhaler or nose spray.
- Are there any foods or beverages to avoid while on this medication?
- Will the drug interfere with other medications my child is taking, or vice-versa?
- List for the pediatrician all medications your teenager takes, including over-the-counter agents, nutritional supplements and “natural” herbal remedies.
- What should we do if we miss a dose?
- For how long must the medicine be taken? Does my child have to finish the entire prescription?
- Does the prescription include refills? If so, how many? What should we do if we need a new prescription ordered?
- What are the potential side effects of this drug, and which ones should we report to you?
- If side effects occur, how will they be managed?
- When will we be able to tell if the medicine is working?
- How much does the prescription cost?
- Is there any written information available about the medication?
Source: Caring for Your Teenager (Copyright © 2003 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.