Medication Barriers and Adherence: Experiences of Pediatric Transplant Recipients.
Medication Barriers and Adherence: Experiences of Pediatric Transplant Recipients.
复制标题
药物障碍和依从性：儿科移植受者的经验。
DOI：
10.1093/hsw/hlac018
复制
发表时间：
2022
影响因子：
1.5
通讯作者：
Desai,Dev
中科院分区：
文献类型：
--
作者：
Killian,MichaelOtis;Triplett,Kelli;Mayersohn,Gillian;Howry,SavarraK;Masood,Saba;Desai,Dev
本研究考察了青少年药物障碍量表（AMBS）和父母药物障碍量表（PMBS）得分、患者和家庭因素以及药物依从性结果之间的关系。来自儿童实体器官移植（SOT）项目的患者和护理人员被招募参与。10 - 21岁的儿科SOT接受者符合参与条件。分析包括通过药物水平变异性指数评分对移植后药物依从性进行可靠性分析和回归建模。73名患者和护理人员完成了AMBS或PMBS问卷调查。病人-照顾者之间的信度从差到公平。据报道，在年轻患者和女性患者以及有更多孩子的家庭中，用药障碍更大。AMBS评分预测更大的不依从性，而PMBS不能预测依从性。结果表明，很难评估药物依从性障碍，青少年患者和护理人员之间缺乏协议。AMBS评分与药物依从性更密切相关，而PMBS评分可能更受家庭社会因素的影响。青少年药物障碍的报告可能会为多学科移植团队提供更大的临床应用，以解决这些挑战与患者。移植社会工作者和心理学家应该让青少年和护理人员参与到解决药物依从性的努力中来。
This study examined associations between scores on the Adolescent Medication Barriers Scale (AMBS) and the Parent Medication Barriers Scale (PMBS), patient and family factors, and medication adherence outcomes. Patients and caregivers from a pediatric solid organ transplantation (SOT) program were recruited for participation. Pediatric SOT recipients ages 10 to 21 years were eligible for participation. Analyses included reliability analyses and regression modeling with posttransplant medication adherence measured by Medication Level Variability Index scores. Seventy-three patients and caregivers completed an AMBS or PMBS questionnaire. Patient–caregiver inter-rater reliability was poor to fair. Greater medication barriers were reported among younger and female patients and families with more children. AMBS scores predicted greater nonadherence, while the PMBS was not predictive of adherence. Results point to the difficulty of assessing barriers to medication adherence and the lack of agreement between adolescent patients and caregivers. AMBS scores were more closely aligned with medication nonadherence, whereas PMBS scores may have been more influenced by family social factors. Adolescent reports of medication barriers may offer multidisciplinary transplant teams greater clinical utility when addressing these challenges with patients. Transplant social workers and psychologists should engage adolescents and caregivers in efforts to address medication nonadherence.