Perceived barriers to medication adherence in pediatric and adolescent solid organ transplantation
Perceived barriers to medication adherence in pediatric and adolescent solid organ transplantation
复制标题
DOI：
10.1111/petr.12648
复制
发表时间：
2016-03-01
影响因子：
1.3
通讯作者：
Sweet, Stuart C.
中科院分区：
文献类型：
--
作者：
Danziger-Isakov, Lara;Frazier, Thomas W.;Sweet, Stuart C.
尽管药物不依从性与不良结局之间存在关联，但尚未系统地比较儿童和青少年SOT患者对坚持治疗的认知障碍。CTOT-C的15个中心招募了患者参加一项横断面研究。受试者的监护人完成了PMBS，8岁以上的受试者完成了青少年量表(AMBS)。评估了三个已确定的PMBS因素和受试者年龄之间的关系。二次分析评估了PMBS、AMBS和患者人口统计学之间的关联。368名受试者或他们的监护人完成了PMBS或AMBS。共有107名6-11岁的受试者；261名12岁的受试者。未经调整和倾向调整的分析表明，与青春期前的监护人相比，青少年的监护人的感知障碍更高，无论器官如何，他们的用药程序和挫折领域(p<；0.05)。PMBS和AMBS的比较显示，监护人报告的摄取问题比患者少(p=0.018)，在日程安排(p=0.025)和挫折感(p=0.019)方面，年轻应答者之间的差异似乎更明显。筛查显示，老年患者的监护人报告说，独立于社会经济地位的坚持增加了感知到的障碍。青少年的监护人报告说，与患者本身相比，他们感觉到的摄入障碍/副作用较少，特别是在青春期前(8-11岁)。在依从性改进计划中，应进一步研究评估感知障碍的简短筛查措施。
Comparisons of perceived barriers to adherence in pediatric and adolescent SOT have not been systematically conducted despite association between medication non-adherence and poor outcome. Fifteen centers in CTOT-C enrolled patients in a cross-sectional study. Subjects' guardians completed the PMBS and subjects over eight completed the Adolescent Scale (AMBS). Association of three identified PMBS factors and subject age was assessed. Secondary analyses assessed associations between PMBS, AMBS, and patient demographics. Three hundred sixty-eight subjects or their guardians completed PMBS or AMBS. A total of 107 subjects were 6-11 yr; 261 were 12. Unadjusted and propensity-adjusted analyses indicated higher perceived barriers in guardians of adolescents as compared to guardians of pre-adolescents medication scheduling and frustration domains regardless of organ (p < 0.05). PMBS and AMBS comparisons revealed that guardians reported fewer ingestion issues than patients (p = 0.018), and differences appeared more pronounced within younger responders for scheduling (p = 0.025) and frustration (p = 0.019). Screening revealed guardians of older patients report increased perceived barriers to adherence independent of socioeconomic status. Guardians of adolescents reported fewer perceived barriers to ingestion/side effects than patients themselves, particularly in pre-adolescents (8-11 yr). Brief screening measures to assess perceived barriers should be further studied in adherence improvement programs.