Patient trust-in-physician and race are predictors of adherence to medical management in inflammatory bowel disease.
Patient trust-in-physician and race are predictors of adherence to medical management in inflammatory bowel disease.
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DOI：
10.1002/ibd.20883
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发表时间：
2009-08
影响因子：
4.9
通讯作者：
Brant, Steven R.
中科院分区：
文献类型：
--
作者：
Nguyen, Geoffrey C.;LaVeist, Thomas A.;Harris, Mary L.;Datta, Lisa W.;Bayless, Theodore M.;Brant, Steven R.
关键词：
依从性在IBD药物治疗的疗效中起着重要作用。我们评估了对医生的信任和黑人种族是否是依从性的预测因素。我们对从门诊IBD诊所招募的黑人（n=120）和白人（n=115） IBD患者进行了横断面研究。采用经验证的工具，分别采用改进的Hill-Bone依从性量表（HBCS）、医生信任量表（TIPS）和IBD短问卷（SIBDQ）来测量自我报告的服药依从性、遵守预约、医生信任和健康相关生活质量。总体依从性为65%。较高的依从性与对医生的更大信任（R= - 0.30； P<0.0001）、年龄增加（R= - 0.19； P=0.01）和健康相关生活质量恶化（R= - 0.18； P=0.01）相关。白人IBD患者的依从性也高于黑人（HBSC: 15.6对14.0，P=0.0002）。在调整就业、收入、健康保险、婚姻和社会经济地位以及免疫调节疗法后，对医生的信任、种族和年龄仍然是坚持医疗管理的预测因素。与白人相比，黑人坚持治疗的调整优势比为0.29 （95% CI: 0.13 - 0.64）。对医生的信任每增加半个标准差和年龄每增加十年，依从性的可能性分别增加36%和47%。对医生的信任是IBD药物治疗依从性的潜在可改变的预测因子。与白人IBD患者相比，黑人IBD患者的依从性较低。了解这些种族差异的机制可能有助于更好地优化治疗效果。
Adherence plays an important role in the therapeutic effectiveness of medical therapy in IBD. We assessed whether trust-in-physician and Black race were predictors of adherence. We performed a cross-sectional study of Black (n=120) and White (n=115) IBD patients recruited from an outpatient IBD clinic. Self-reported adherence to taking medication and keeping appointments, trust-in-physician, and health-related quality of life were measured using the validated instruments, the modified Hill-Bone Compliance Scale (HBCS), the Trust-in-Physician Scale (TIPS), and the Short IBD Questionnaire (SIBDQ) respectively. Overall adherence was 65%. Higher adherence correlated with greater trust-in-physician (R=−0.30; P<0.0001), increasing age (R=−0.19; P=0.01), and worsening health-related quality of life (R=−0.18; P=0.01). Adherence was also higher among White IBD patients compared to Blacks (HBSC: 15.6 versus 14.0, P=0.0002). Trust-in-physician, race, and age remained predictors of adherence to medical management after adjustment for employment, income, health insurance, marital and socioeconomic status, and immunomodulator therapy. The adjusted odds ratio for adherence in Blacks compared to Whites was 0.29 (95% CI: 0.13 – 0.64). Every half standard deviation increase in trust-in-physician and every incremental decade in age were associated with 36% and 47% higher likelihood of adherence, respectively. Trust-in-physician is a potentially modifiable predictor of adherence to IBD medical therapy. Black IBD patients exhibited lower adherence compared to their White counterparts. Understanding the mechanisms of these racial differences may lead to better optimization of therapeutic effectiveness.
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影响因子：
4.1
作者：
Morris, AB;Li, JJ;Murray, MD
通讯作者：
Murray, MD
影响因子：
5.1
作者：
O'Malley, AS;Sheppard, VB;Mandelblatt, J
通讯作者：
Mandelblatt, J
影响因子：
3.1
作者：
Bernal, Isabel;Domenech, Eugeni;Gassull, Miquel A.
通讯作者：
Gassull, Miquel A.
影响因子：
8.3
作者：
HAYNES, RB;TAYLOR, DW;MUKHERJEE, J
通讯作者：
MUKHERJEE, J
影响因子：
7.2
作者：
SANDLER, RS;JORDAN, MC;KUPPER, LL
通讯作者：
KUPPER, LL