{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T07:09:05Z","timestamp":1780988945760,"version":"3.54.1"},"reference-count":6,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,5,12]],"date-time":"2026-05-12T00:00:00Z","timestamp":1778544000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,12]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Medication adherence is a modifiable determinant of successful therapy. Adhering to pharmacologic regimens to treat eosinophilic esophagitis (EoE) can be complicated and burdensome, yet the impact of medication adherence, particularly the self-reported adherence, on EoE activity indices remains understudied. We assessed the association between self-reported adherence to pharmacologic EoE therapy and endoscopic (EoE Endoscopic Reference Score, EREFS; range = 0-9), histologic (peak eosinophil count), and multidimensional Index of Severity for EoE in a prospectively followed pediatric cohort between 2017 and 2024, cross-sectionally and longitudinally, with up to three EGD time points. Self-reported adherence was collected during routine pre-EGD assessment as a percentage of the inter-EGD interval (12\u201316\u00a0weeks). Hierarchical variable clustering was applied to reduce multicollinearity. Our cohort comprised 103 children with an index EGD (EGD 1); 36 and 19 had EGDs at time points 2 and 3, respectively. At EGD 1, children with abnormal esophageal mucosa (EREFS \u22651) had 8% lower self-reported adherence (95% CI: 1\u201315%; P\u2009=\u20090.02) than those with normal esophageal mucosa (EREFS\u2009=\u20090). Additionally, for each 5-year increase in age, the self-reported adherence decreased by 5% (95% CI: 1\u201310%; P\u2009=\u20090.05). These trends persisted over time between EGD 1 and EGD 2. Self-reported adherence was not associated with peak eosinophil count, Index of Severity for EoE score, or complexity of pharmacologic regimen. Despite a median adherence of &amp;gt;95%, more than half had active EoE, highlighting the limited reliability of self-report alone. These findings suggest that self-reported adherence aligns with endoscopic, but not with histologic, disease activity and decreases with age, underscoring the need for age-appropriate adherence counseling and objective adherence monitoring in pediatric EoE management.<\/jats:p>","DOI":"10.1093\/dote\/doag055","type":"journal-article","created":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T11:41:33Z","timestamp":1779277293000},"source":"Crossref","is-referenced-by-count":0,"title":["Self-reported medication adherence and disease activity in pediatric eosinophilic esophagitis: lessons from a real-world cohort"],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9613-1707","authenticated-orcid":false,"given":"Girish","family":"Hiremath","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lili","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yash","family":"Choksi","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology, Hepatology and Nutrition, Department of Medicine, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Regina","family":"Tyree","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0528-4896","authenticated-orcid":false,"given":"Hernan","family":"Correa","sequence":"additional","affiliation":[{"name":"Department of Pathology, Microbiology and Immunology, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sari","family":"Acra","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuki","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Vanderbilt University Medical Center , Nashville, TN ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan S","family":"Dellon","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Gastroenterology and Hepatology, University of North Carolina , Chapel Hill, NC ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,8]]},"reference":[{"key":"2026060902522558200_ref1","doi-asserted-by":"crossref","first-page":"31","DOI":"10.14309\/ajg.0000000000003194","article-title":"ACG clinical guideline: diagnosis and Management of Eosinophilic Esophagitis","volume":"120","author":"Dellon","year":"2025","journal-title":"Am J Gastroenterol"},{"key":"2026060902522558200_ref2","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1002\/jpr3.70031","article-title":"Barriers to treatment adherence in pediatric eosinophilic esophagitis","volume":"6","author":"Primo","year":"2025","journal-title":"JPGN Rep"},{"key":"2026060902522558200_ref3","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/00005650-198601000-00007","article-title":"Concurrent and predictive validity of a self-reported measure of medication adherence","volume":"24","author":"Morisky","year":"1986","journal-title":"Med Care"},{"key":"2026060902522558200_ref4","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1136\/gutjnl-2011-301817","article-title":"Endoscopic assessment of the oesophageal features of eosinophilic oesophagitis: validation of a novel classification and grading system","volume":"62","author":"Hirano","year":"2013","journal-title":"Gut"},{"key":"2026060902522558200_ref5","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jaci.2022.03.015","article-title":"A clinical severity index for eosinophilic esophagitis: development, consensus, and future directions","volume":"150","author":"Dellon","year":"2022","journal-title":"J Allergy Clin Immunol"},{"key":"2026060902522558200_ref6","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/j.jclinepi.2013.08.015","article-title":"Systematic review of the Hawthorne effect: new concepts are needed to study research participation effects","volume":"67","author":"McCambridge","year":"2014","journal-title":"J Clin Epidemiol"}],"container-title":["Diseases of the Esophagus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/39\/3\/doag055\/68491057\/doag055.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/dote\/article-pdf\/39\/3\/doag055\/68491057\/doag055.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T06:52:35Z","timestamp":1780987955000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/dote\/article\/doi\/10.1093\/dote\/doag055\/8704051"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,12]]},"references-count":6,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,5,12]]}},"URL":"https:\/\/doi.org\/10.1093\/dote\/doag055","relation":{},"ISSN":["1120-8694","1442-2050"],"issn-type":[{"value":"1120-8694","type":"print"},{"value":"1442-2050","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,5,12]]},"article-number":"doag055"}}