Nonadherence with thiopurine immunomodulator and mesalarnine medications in children with Crohn disease
Nonadherence with thiopurine immunomodulator and mesalarnine medications in children with Crohn disease
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DOI：
10.1097/mpg.0b013e31802b320e
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发表时间：
2007-02-01
影响因子：
2.9
通讯作者：
Thompson, Richard E.
中科院分区：
文献类型：
--
作者：
Oliva-Heraker, Maria M.;Abadom, Vivian;Thompson, Richard E.
目的：为了评估的患病率与克罗恩病的儿童遵守处方药物，并确定可能的因素与nonadherence.Patients和方法：这是一个横断面研究的51例小儿克罗恩病谁是规定的维持治疗与硫嘌呤免疫调节剂（6-巯基嘌呤或硫唑嘌呤）和/或美沙拉嗪在180天的时间。使用药房记录，根据经验证的公式计算药物依从率，不依从定义为处方药物的补充率< 80%。75%的患者开了巯嘌呤免疫调节剂，86%开了美沙拉嗪。结果：不遵守的患病率为50%的巯嘌呤免疫调节剂和66%的美沙拉嗪。坚持使用美沙拉嗪的患者的平均急诊就诊次数显著高于不坚持使用美沙拉嗪的患者（P < 0.0008）。急诊就诊使患者坚持美沙拉嗪治疗的机会增加了9倍（比值比，9.6; 95%置信区间，1.87-52.17）。坚持使用美沙拉嗪的患者的平均总医疗保健就诊次数（6.1 ± 0.8）显著高于不坚持使用美沙拉嗪的患者（3.0 ± 0.4）（P < 0.001）。结论：这些结果表明，儿童克罗恩病患者不坚持使用硫嘌呤免疫调节剂或美沙拉嗪是常见的。有一个健康护理访问与被遵守。
Objectives: To assess the prevalence of adherence to prescribed medications in children with Crohn disease and to identify possible factors associated with nonadherence.Patients and Methods: This was a cross-sectional study of 51 pediatric patients with Crohn disease who were prescribed maintenance therapy with a thiopurine immunomodulator (6-mercaptopurine or azathioprine) and/or mesalamine during a 180-day period. Medication adherence rates were calculated from a validated formula using pharmacy records, and nonadherence was defined as a refill rate of < 80% of the prescribed medication. Seventy-five percent of patients were prescribed thiopurine immunomodulators and 86% were prescribed mesalamine.Results: The prevalence of nonadherence was 50% for the thiopurine immunomodulators and 66% for mesalamine. The mean number of emergency department visits for patients adherent to mesalamine was significantly greater than the nonadherent group (P < 0.0008). Having an emergency department visit increased the chances of a patient being adherent to mesalamine therapy by > 9-fold (odds ratio, 9.6; 95% confidence interval, 1.87-52.17). The mean number of total health care visits was significantly greater for patients adherent to mesalamine (6.1 +/- 0.8) compared with those who were not adherent (3.0 +/- 0.4) (P < 0.001).Conclusions: These findings suggest that nonadherence to thiopurine immunomodulator or mesalamine therapy in pediatric patients with Crohn disease is common. Having a health care visit was associated with being adherent.