A review of adolescent adherence in type 1 diabetes and the untapped potential of diabetes providers to improve outcomes.
A review of adolescent adherence in type 1 diabetes and the untapped potential of diabetes providers to improve outcomes.
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DOI：
10.1007/s11892-015-0621-6
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发表时间：
2015-08
影响因子：
4.2
通讯作者：
Jaser SS
中科院分区：
文献类型：
--
作者：
Datye KA;Moore DJ;Russell WE;Jaser SS
只有21%的患有1型糖尿病(T1D)的青少年达到了美国糖尿病协会设定的血糖目标。对治疗的依从性在这一人群中是一个特别令人担忧的问题，依从性差与血糖控制恶化之间的关联表明，在患有T1D的青少年中，迫切需要提高对治疗的依从性。在这篇文章中，我们回顾了患有T1D的青少年坚持治疗的障碍，并讨论了旨在提高治疗依从性和血糖控制的干预措施。干预措施包括基于技术的应用、基于家庭的治疗、激励性访谈等。值得注意的是，在审查的干预措施中，只有不到10%是提供者主导的、以临床为基础的干预措施，很少有人关注与方案相关的依从性方面。这篇文章还概述了提供者沟通的重要性以及提供者在促进患有T1D的青少年遵守行为方面的作用。最后，我们建议未来的研究方向，以提高青少年T1D患者对治疗的依从性。
Only 21 % of adolescents with type 1 diabetes (T1D) meet glycemic goals set forth by the American Diabetes Association. Adherence to therapy is a particular concern in this population, and the association between poor adherence and worsening glycemic control indicates that there is a critical need to improve adherence to therapy in adolescents with T1D. In this article, we review barriers to adherence in adolescents with T1D and discuss interventions aimed at improving adherence to therapy and glycemic control. Interventions include technology-based applications, family-based therapies, motivational interviewing, and others. Notably, less than 10 % of the interventions reviewed are provider-led, clinic-based interventions, and few have focused on regimen-related aspects of adherence. This article also outlines the importance of provider communication and the role of providers in facilitating adherence behaviors in adolescents with T1D. Finally, we suggest future directions of research to improve adherence to therapy in adolescents with T1D.