Oral medication adherence in pediatric inflammatory bowel disease
Oral medication adherence in pediatric inflammatory bowel disease
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DOI：
10.1097/01.mib.0000186409.15392.54
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发表时间：
2005-11-01
影响因子：
4.9
通讯作者：
Crandall, WV
中科院分区：
文献类型：
--
作者：
Mackner, LM;Crandall, WV
本研究的目的是检查口服药物的依从性报告，依从性报告中的亲子一致性，以及与炎症性肠病（IBD）青少年依从性差相关的因素。参与者是50名11至17岁的IBD儿童及其父母。父母完成了依从性访谈和儿童行为检查表，家庭评估设备和人口统计调查问卷。另外，青少年完成了依从性访谈和皮尔斯哈里斯自我概念量表，儿童抑郁量表和应对策略量表问卷。参与儿童的治疗胃肠病学家在完成问卷后一周内的门诊访视期间完成了小儿克罗恩病活动指数。父母和孩子报告的平均依从性得分落在“大部分时间”和“总是”类别之间，尽管完美的依从性很低。在IBD特定药物（5-ASA，免疫调节剂，类固醇）中，48%的儿童和38%的父母报告始终坚持所有药物。亲子一致性很高。家庭功能障碍和不良的儿童应对策略与更差的依从性相关。更多的行为/情绪问题和较低的依从性之间的相关性接近显著性。在缺乏适当的儿童纪律的家庭中，以及在仅仅希望压力源科普的儿童中，应该监测依从性。由于这些问题与依从性差有关，因此有人建议，解决这些问题的心理治疗可能有助于提高依从性。
The purpose of this study was to examine reports of adherence to oral medications, parent-child concordance in reports of adherence, and factors associated with poor adherence in adolescents with inflammatory bowel disease (IBD). Participants were 50 children with IBD 11 to 17 years of age and their parents. Parents completed an adherence interview and the Child Behavior Checklist, Family Assessment Device, and demographics questionnaires. Separately, adolescents completed the adherence interview and the Piers Harris Self-Concept Scale, Children's Depression Inventory, and Coping Strategies Inventory questionnaires. The treating gastroenterologists of participating children completed the Pediatric Crohn's Disease Activity Index during a clinic visit within a week of completion of the questionnaires. Mean parent- and child-reported adherence scores fell between the "most of the time" and "always" categories, although perfect adherence was low. Among IBD-specific medications (5-ASAs, immunomodulators, steroids), 48% of children and 38% of parents reported being always adherent to all medications. Parent-child concordance was high. Family dysfunction and poor child coping strategies were associated with worse adherence. The correlation between more behavioral/emotional problems and lower adherence approached significance. Adherence should be monitored in families that lack appropriate child discipline and in children who cope by simply wishing stressors would go away. Because these issues are associated with poor adherence, it has been suggested that psychotherapy addressing these areas may contribute to improved adherence.