Family Strategies for Achieving Medication Adherence in Pediatric Kidney Transplantation
Family Strategies for Achieving Medication Adherence in Pediatric Kidney Transplantation
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DOI：
10.1097/nnr.0b013e318215fdfe
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发表时间：
2011-05-01
期刊：
影响因子：
2.5
通讯作者：
Pai, Ahna L. H.
中科院分区：
文献类型：
--
作者：
Ingerski, Lisa;Perrazo, Lauren;Pai, Ahna L. H.
工作背景：虽然不依从性已被充分记录，并且依从性策略已被证明对克服障碍和提高总体依从率至关重要，但尚不清楚家庭策略的使用与儿科肾移植人群的依从性之间的关系。目的：本研究的目的是评估（a）接受肾移植的青少年及其照顾者坚持移植后口服药物治疗方案的策略，以及（B）这些策略的关系，以客观的adherence.Methods：半结构式访谈，以评估自我管理，17名青少年（14-18岁）和17名照顾者。坚持口服免疫抑制剂药物，通过电子监测器测量，也被确定为一个子集的13 dyads.Results：共同的战略赞同的家庭包括以下内容：让它成为日常生活的一部分（88.2%），看护者口头提醒（82.4%）、照顾者确认服用药物（76.5%）、将药物放置在方便的位置（76.5%）和使用药盒（70.6%）。更多的家庭认可的策略与更高水平的依从性相关。这些策略自发认可，只有照顾者提醒采取药物和照顾者的验证，采取了药物治疗显着相关的更高的adherence rates.Discussion：研究结果强调了识别和使用特定的策略，以提高儿童肾移植受者的依从率的重要性，并强调需要继续照顾者参与促进治疗方案的依从性。
Background: Although nonadherence is well documented and strategies for adherence have been shown to be critical to overcoming barriers and improving overall adherence rates, it is unknown how family strategy use is related to adherence in the pediatric renal transplant population.Objectives: The aims of this study were to assess (a) the strategies used by adolescents with kidney transplants and their caregivers to adhere to the posttransplant oral medication regimen and (b) the relationship of these strategies to objective adherence rates.Methods: Semistructured interviews to assess self-management were administered to 17 adolescents (14-18 years) and 17 caregivers. Adherence to oral immunosuppressant medication, measured via electronic monitors, was determined also for a subset of 13 dyads.Results: Common strategies endorsed by families included the following: making it part of the routine (88.2%), verbal reminders by caregiver (82.4%), caregiver verifying medication was taken (76.5%), placing medication in a convenient location (76.5%), and using a pillbox (70.6%). A greater number of family-endorsed strategies were correlated with higher levels of adherence. Of those strategies spontaneously endorsed, only caregiver reminders to take medication and caregiver verification that medications were taken were related significantly to higher adherence rates.Discussion: The findings highlight the importance of identification and use of specific strategies to improve adherence rates of pediatric renal transplant recipients and emphasize the need for continued caregiver involvement in the promotion of adherence to the treatment regimen.