Objective versus subjective assessment of oral medication adherence in pediatric inflammatory bowel disease.
Objective versus subjective assessment of oral medication adherence in pediatric inflammatory bowel disease.
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DOI：
10.1002/ibd.20798
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发表时间：
2009-04
影响因子：
4.9
通讯作者：
Baldassano, Robert N.
中科院分区：
文献类型：
--
作者：
Hommel, Kevin A.;Davis, Christine M.;Baldassano, Robert N.
使用多方法评估方法（包括客观、主观和生物学数据）检查IBD青少年口服药物不依从性的患病率和频率。在42名患有炎症性肠病的青少年中，通过药丸计数、患者/家长访谈和6-硫代鸟嘌呤核苷酸（6-TGN）/6-甲巯基嘌呤核苷酸（6-MMPN）代谢物生物测定来评估药物依从性。儿科胃肠病学家提供了疾病严重程度评估。6-MP/硫唑嘌呤的客观不依从率为64%，5-阿萨为88%，而6-MP/硫唑嘌呤的主观不依从率为10%，5-阿萨为2%。6-MP/硫唑嘌呤的客观不依从率为38%，5-阿萨为49%，6-MP/硫唑嘌呤的主观不依从率为6%，5-阿萨为3%。生物测定数据显示，只有14%的患者具有治疗性6-TGN水平。结果表明，客观测量的药物不依从性患病率与其他儿科慢性病人群中观察到的一致，客观不依从频率相当高，患者漏服剂量的40%至50%。主观评估似乎高估了依从性。生物测定依从性数据，虽然受到药代动力学变化的影响，但可能有助于作为随访客观评估不依从性的粗略筛选。一种药物的不依从也可能表明其他药物的不依从。临床意义和未来的研究方向。
To examine prevalence and frequency of oral medication nonadherence using a multimethod assessment approach consisting of objective, subjective, and biological data in adolescents with IBD. Medication adherence was assessed via pill counts, patient/parent interview, and 6-thioguanine nucleotide (6-TGN)/6-methylmercaptopurine nucleotide (6-MMPN) metabolite bioassay in 42 adolescents with inflammatory bowel disease. Pediatric gastroenterologists provided disease severity assessments. Objective nonadherence prevalence was 64% for 6-MP/azathioprine and 88% for 5-ASA medications, whereas subjective nonadherence prevalence was 10% for 6-MP/azathioprine and 2% for 5-ASA. Objective nonadherence frequency was 38% for 6-MP/azathioprine and 49% for 5-ASA medications, and subjective nonadherence frequency was 6% for 6-MP/azathioprine and 3% for 5-ASA. Bioassay data revealed that only 14% of patients had therapeutic 6-TGN levels. Results indicate that objectively measured medication nonadherence prevalence is consistent with that observed in other pediatric chronic illness populations, and that objective nonadherence frequency is considerable, with 40% to 50% of doses missed by patients. Subjective assessments appeared to overestimate adherence. Bioassay adherence data, while compromised by pharmacokinetic variation, might be useful as a cursory screener for nonadherence with follow up objective assessment. Nonadherence in one medication might also indicate nonadherence in other medications. Clinical implications and future research directions are provided.
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影响因子：
1.9
作者：
Belaiche, J;Desager, JP;Louis, E
通讯作者：
Louis, E
影响因子：
3.1
作者：
Bernal, Isabel;Domenech, Eugeni;Gassull, Miquel A.
通讯作者：
Gassull, Miquel A.
影响因子：
4.9
作者：
Mackner, LM;Crandall, WV
通讯作者：
Crandall, WV
DOI：
10.1097/mpg.0b013e31802b320e
发表时间：
2007-02-01
影响因子：
2.9
作者：
Oliva-Heraker, Maria M.;Abadom, Vivian;Thompson, Richard E.
通讯作者：
Thompson, Richard E.
影响因子：
29.4
作者：
Dubinsky, MC;Lamothe, S;Seidman, EG
通讯作者：
Seidman, EG