Adherence to Pediatric Asthma Treatment in Economically Disadvantaged African-American Children and Adolescents: An Application of Growth Curve Analysis
Adherence to Pediatric Asthma Treatment in Economically Disadvantaged African-American Children and Adolescents: An Application of Growth Curve Analysis
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DOI：
10.1093/jpepsy/jsp074
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发表时间：
2010-05-01
影响因子：
3.6
通讯作者：
Kercsmar, Carolyn
中科院分区：
文献类型：
--
作者：
Rohan, Jennifer;Drotar, Dennis;Kercsmar, Carolyn
目的本研究的主要目的是：（a）基于生长曲线模型，描述经济困难的非洲裔美国青年哮喘患者一年内每日吸入皮质类固醇（ICS）药物治疗依从性的轨迹;（B）检验治疗依从性与症状控制、快速缓解药物和医疗保健利用的关系。方法本前瞻性研究采用电子监测技术，对92例中重度哮喘儿童和青少年进行9-12个月的每日ICS治疗依从性进行测量，并评估临床结局，包括哮喘相关症状、快速缓解药物和医疗保健利用。结果：在研究过程中，年轻人对不到一半的处方糖皮质激素治疗的依从性下降，这与医疗保健利用率增加有关（p <0.04），但与哮喘症状或沙丁胺醇使用无关。结论：经济困难的哮喘青年表现出较高的慢性不依从率，需要识别和干预，以减少哮喘相关的医疗保健利用。
Objectives The primary aims of the study were to: (a) describe the trajectories of adherence to daily inhaled corticosteroid (ICS) medication for a year in economically disadvantaged, African-American youth with asthma based on growth curve modeling; and (b) test the relationship of treatment adherence to symptom control, quick-relief medication, and healthcare utilization. Methods This prospective study measured adherence to daily ICS treatment using electronic monitoring in 92 children and adolescents with moderate to severe asthma for 9-12 months and assessed clinical outcomes, including asthma-related symptoms, quick-relief medication, and healthcare utilization. Results Youth showed a decrement in treatment adherence to less than half of prescribed corticosteroid treatment over the course of the study, which related to increased healthcare utilization (p < .04), but not to asthma symptoms or albuterol use. Conclusion Economically disadvantaged youth with asthma demonstrate high rates of chronic nonadherence that warrant identification and intervention to reduce asthma-related healthcare utilization.