Medication adherence in youths with CKD: habits for success.
Medication adherence in youths with CKD: habits for success.
复制标题
慢性肾病青少年的药物依从性：成功的习惯。
DOI：
10.1007/s00467-023-05976-0
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Riekert,KristinA
中科院分区：
文献类型：
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作者：
Eaton,CydK;Comer,Margaret;Pruette,CozumelS;Riekert,KristinA
背景不良的依从性习惯是不依从的关键因素，但临床上很少有可行的方法来评估依从性习惯，特别是对患有慢性肾脏病（CKD）的青少年。本研究调查了参与者的定性反应，三个面试问题的坚持习惯映射到习惯形成的主要原则，客观地衡量药物治疗的坚持与CKD.MethodsParticipants（年龄11-21岁）的青少年被招募从儿科肾病诊所作为一个更大的研究的一部分。在4周的基线期内，使用电子药瓶测量参与者的每日客观抗高血压药物依从性。关于坚持习惯和惯例的定性访谈进行了一个子集的参与者（N= 18）。ResultsClear质的差异出现在如何与高中坚持（80-100%）的参与者讨论坚持的习惯相比，低坚持（0-79%）的参与者。高-中依从性的参与者讨论了服药的情境线索，包括提示依从性的位置，导致服药的一步一步的事件，以及提示依从性的人。高依从性的参与者经常将服药描述为“自动”，“第二天性”和“习惯”。低依从性的参与者很少讨论这些习惯特征，也没有明确承认目前缺少剂量。低坚持的参与者往往讨论的挑战与组织和例行taking medicine.ConclusionsEvaluating患者的反应问题的坚持习惯可能会发现挑战与坚持习惯的形成，提供方向习惯加强干预，重点是发展自动线索服药，临床试验注册号NCT 03651596.图形摘要图形摘要的高分辨率版本可作为补充信息提供
BackgroundPoor adherence habits are key contributors to nonadherence but there are few clinically feasible methods for evaluating adherence habits, particularly for youths with chronic kidney disease (CKD). This study investigated how participants’ qualitative responses to three interview questions about adherence habits mapped to primary principles of habit formation and objectively measured medication adherence in youths with CKD.MethodsParticipants (ages 11–21 years) were recruited from a pediatric nephrology clinic as part of a larger study. Participants’ daily objective antihypertensive medication adherence was measured with an electronic pill bottle over a 4-week baseline period. Qualitative interviews about adherence habits and routines were conducted with a subset of participants (N= 18).ResultsClear qualitative differences emerged in how participants with high-medium adherence (80–100%) discussed adherence habits compared to participants with low adherence (0–79%). Participants with high-medium adherence discussed situational cues for taking medicine, including locations that cue adherence, step-by-step events leading up to taking medicine, and people who cue adherence. Participants with high-medium adherence regularly described taking medicine as “automatic,” “second nature,” and a “habit.” Participants with low adherence rarely discussed these habit features nor did they explicitly acknowledge currently missing doses. Participants with low adherence tended to discuss challenges with organization and routines for taking medicine.ConclusionsEvaluating patient responses to questions about adherence habits may uncover challenges with adherence habit formation, provide direction for habit-strengthening intervention focused on developing automatic cues for taking medication, and support adherence successes for youths with CKD.Clinical trial registration numberNCT03651596.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information