Measuring adherence to medical treatments in childhood chronic illness: Considering multiple methods and sources of information
Measuring adherence to medical treatments in childhood chronic illness: Considering multiple methods and sources of information
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DOI：
10.1023/a:1009545319673
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发表时间：
2000-03-01
影响因子：
2.2
通讯作者：
Drotar, D
中科院分区：
文献类型：
--
作者：
Quittner, AL;Espelage, DL;Drotar, D
对于患有慢性疾病（如哮喘、糖尿病和囊性纤维化）的儿童和青少年来说，坚持药物治疗是一个重大问题。不依从的后果可能很严重，导致症状增加、不必要的住院和身体功能下降。从临床试验中获得的数据质量也可能受到依从性差的影响，导致关于药物治疗效果和实现这些效果所需剂量的错误结论。临床研究和实践中的依从性问题也导致医疗保健费用大幅增加。为了进一步了解导致依从性差的障碍，并确定有效解决这些障碍的策略，我们需要制定可靠有效的依从性行为测量方法。使用囊性纤维化作为一种严重的慢性疾病，需要一个困难和耗时的医疗方案的模型，三种不同类型的坚持措施被认为是：自我报告问卷，每日日记报告，和电子监视器。每种类型的测量的具体优点和缺点进行了审查，并提出了具体的建议，为今后的研究。
Adherence to medical treatment is a significant problem for children and adolescents with chronic conditions, such as asthma, diabetes, and cystic fibrosis. The consequences of nonadherence can be serious, contributing to increased symptoms, unnecessary hospitalizations, and declines in physical functioning. The quality of data obtained from clinical trials can also be affected by poor adherence, leading to erroneous conclusions concerning the efficacy of drug treatments and the dosages that are needed to achieve those effects. Adherence problems in both clinical research and practice also lead to substantially higher health care costs. In order to further our understanding of the barriers that lead to poor adherence and identify strategies that are effective in addressing them, we need to develop reliable and valid measures of adherence behaviors. Using cystic fibrosis as a model of a serious, chronic disease that requires a difficult and time-consuming medical regimen, three different types of adherence measures are considered: self-report questionnaires, daily diary reports, and electronic monitors. The specific advantages and disadvantages of each type of measurement are reviewed, and specific recommendations are made for future research.