Patterns of Asthma Medication Use across the Transition to High School.
Patterns of Asthma Medication Use across the Transition to High School.
复制标题
高中过渡期间哮喘药物的使用模式。
DOI：
10.1093/jpepsy/jsab001
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发表时间：
2021
影响因子：
3.6
通讯作者：
Dunsiger,Shira
中科院分区：
文献类型：
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作者：
McQuaid,ElizabethL;Kopel,SherylJ;Seifer,Ronald;Tackett,Alayna;Farrow,Michael;Koinis-Mitchell,Daphne;Dunsiger,Shira
目的在青少年中，对哮喘控制药物的依从性并不理想。我们在不同种族/民族的青少年样本中评估了8到10年级的依从性和纵向用药模式的预测因素。方法8年级的哮喘患者接受控制性药物治疗(N=62；40.0%非拉丁裔白人；23.7%黑人；37.3%拉丁裔；37.3%女性)完成了药物信念、哮喘管理责任和家庭凝聚力的测量。结果服药依从性从8年级的48.0%下降到10年级的34.1%(F=5.35，p<；0.01)。男性的依从性较低(b=−10.11，SE=5.37，p=0.02，f2=0.11)，拉丁裔青年的依从性较低(b=−12.21，SE=8.23，p=0.03，f2=0.12)。家庭凝聚力与较高的依从性相关(b=4.38，SE=1.98，p=0.04，f2=0.06)。潜在类模型(LCMS)提出了纵向依附模式的三类模型。这包括低依从性(1级 = 29%；男性比例较高，p=0.02)，高、持续依从性(2级 = 26%，高家庭凝聚力，p=0.05，女性比例较高，p=02)，以及低、持续依从性(3级 = 45%；拉丁裔比例较高，p=0.05，男性比例较高，p=0.02)。LCMS表明，一些年轻人有稳定的坚持模式(高或低)，而另一些年轻人则表现出下降。性别差异被观察到，家庭凝聚力与更高、更持久的忠诚度相关。建立在家庭资源基础上的干预措施和针对青少年面临的障碍，对于改善这一脆弱时期的哮喘管理是必要的。
ObjectiveAdherence to asthma controller medications is suboptimal among adolescents. We evaluated predictors of adherence and longitudinal patterns of medication use between 8th and 10th grade among a sample of youth of diverse race/ethnicity.MethodsEighth graders with asthma on controller medications (N=62; 40.0% non-Latino white; 23.7% Black; 37.3% Latino; 37.3% female) completed measures of medication beliefs, responsibility for asthma management, and family cohesion. Objective methods tracked medication use longitudinally.ResultsAdherence declined during the high school transition, from 48.0% in eighth grade to 34.1% in tenth grade (F=5.35,p< .01). Males had lower adherence (b= −10.11, SE=5.37,p= .02,f2= 0.11), as did Latino youth (b= −12.21, SE=8.23,p= .03,f2= 0.12). Family cohesion was associated with higher adherence (b=4.38, SE=1.98,p= .04,f2= 0.06). Latent class models (LCMs) suggested a three-class model of longitudinal adherence patterns. This included low, declining adherence (Class 1 = 29%; higher proportion male,p= .02), high, sustained adherence (Class 2 = 26%, high family cohesion,p= .05, higher proportion female,p= .02), and low, sustained adherence (Class 3 = 45%; higher proportion Latino,p= .05, higher proportion male,p= .02).ConclusionsAsthma medication adherence declined between 8th and 10th grade. LCMs indicated some youth have stable patterns of adherence (high or low), whereas others demonstrate declines. Gender differences were observed, and family cohesion was associated with higher, sustained adherence. Interventions building on family resources and targeting the barriers adolescents face are necessary to improve asthma management during this vulnerable period.