Executive functioning, caregiver monitoring, and medication adherence over time in adolescents with chronic kidney disease.
Executive functioning, caregiver monitoring, and medication adherence over time in adolescents with chronic kidney disease.
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患有慢性肾脏疾病的青少年的执行功能，护理人员监测和药物依从性。
DOI：
10.1037/hea0000851
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发表时间：
2020-06
期刊：
影响因子：
--
通讯作者：
Riekert KA
中科院分区：
文献类型：
--
作者：
Eaton CK;Duraccio KM;Eakin MN;Brady TM;Pruette CS;Eckmann T;Mendley SR;Tuchman S;Fivush BA;Riekert KA
评估慢性肾病（CKD）青少年患者执行功能和护理依从性监测与24个月以上客观降压药物依从性之间的关系。从三家儿科肾脏科诊所招募了97名服用抗高血压药物的CKD青少年（11-20岁）及其护理人员。在基线时，青少年和照顾者报告青少年的执行功能，照顾者报告他们的依从性监测。在基线和24个月后每6个月通过电子监测客观评估降压药物依从性。使用线性混合模型评估执行功能、照顾者监测和纵向依从性之间的关系。高达38%的青少年执行功能得分升高，表明更严重的损伤，比例因量表和报告者（青少年与照顾者）而异。照顾者监测显示与依从性显著负相关，但青少年的执行功能与依从性无显著相关。这两个变量都与依从性随时间的变化率无关。鉴于青少年的执行功能与抗高血压药物依从性或依从性随时间的变化无关，与更复杂的医疗方案相比，每天坚持服用药片形式的药物可能需要更少的认知努力。出乎意料的是，高水平的护理人员监控与低水平的依从性相关。这一意想不到的发现可能反映了在面对青少年药物依从性时，护理人员加强了监测工作，但这一发现值得进一步调查。非依从性的青少年慢性肾病患者可能受益于药物依从性促进策略，而不是增加护理人员的监测。
To evaluate associations between executive functioning and caregiver adherence monitoring with objective antihypertensive medication adherence over 24 months in adolescents with chronic kidney disease (CKD). Adolescents (N = 97, 11–20 years old) with CKD taking antihypertensive medication and their caregivers were recruited from three pediatric nephrology clinics. At baseline, adolescents and caregivers reported on adolescents’ executive functioning and caregivers reported on their adherence monitoring. Antihypertensive medication adherence was objectively assessed via electronic monitoring at baseline and every 6 months after for 24 months. Associations between executive functioning, caregiver monitoring, and longitudinal adherence were evaluated with linear mixed models. Up to 38% of adolescents had elevated executive functioning scores indicating more severe impairments, with rates varying by scale and reporter (adolescent versus caregiver). Caregiver monitoring showed a significant, negative association with adherence, but adolescents’ executive functioning was not significantly associated with adherence. Neither variable was associated with the rate of change in adherence over time. Given that adolescents’ executive functioning was not associated with antihypertensive medication adherence or changes in adherence over time, adherence to daily pill-form medications may involve less cognitive effort than more complex medical regimens. Higher levels of caregiver monitoring were unexpectedly associated with lower adherence levels. This unanticipated finding may reflect increased caregiver monitoring efforts when faced with adolescents’ medication nonadherence, but this finding warrants further investigation. Adolescents with CKD who are nonadherent may benefit from medication adherence-promoting strategies beyond increasing caregiver monitoring.
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DOI：
10.1017/s1355617714001027
发表时间：
2015-01
期刊：
Journal of the International Neuropsychological Society : JINS
影响因子：
--
作者：
Cassidy AR;White MT;DeMaso DR;Newburger JW;Bellinger DC
通讯作者：
Bellinger DC
影响因子：
19.6
作者：
通讯作者：
--
DOI：
10.2215/cjn.09751110
发表时间：
2011-08-01
影响因子：
9.8
作者：
Hooper, Stephen R.;Gerson, Arlene C.;Warady, Bradley A.
通讯作者：
Warady, Bradley A.
影响因子：
3.6
作者：
Holbein, Christina E.;Smith, Aimee W.;Modi, Avani C.
通讯作者：
Modi, Avani C.
影响因子：
16.2
作者：
Berg, Cynthia A.;Wiebe, Deborah J.;Murray, Mary
通讯作者：
Murray, Mary