Measurement of children's asthma medication adherence by self report, mother report, canister weight, and Doser CT
Measurement of children's asthma medication adherence by self report, mother report, canister weight, and Doser CT
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DOI：
10.1016/s1081-1206(10)62557-4
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发表时间：
2000-11-01
影响因子：
5.9
通讯作者：
Wamboldt, MZ
中科院分区：
文献类型：
--
作者：
Bender, B;Wamboldt, FS;Wamboldt, MZ
背景：准确评估服药依从性一直很难实现，但对于临床试验中的药物评估和改善临床护理结果是必不可少的。目的：本研究比较了4种依从性评估方法：儿童报告、母亲报告、罐子重量和计量吸入器(MDI)启动的电子测量。方法：参与者包括27例轻中度哮喘儿童，前瞻性随访6个月。所有患者都使用MDI，在他们吸入的类固醇上安装了一个电子Doser。在每次2个月的随访中，记录儿童和母亲的体重数据，并分别询问儿童和母亲的用药情况。结果：儿童和母亲报告平均80%以上的人遵守处方的吸入性类固醇。罐子重量显示，平均坚持69%，明显低于自我报告。当电子Doser记录的依从性被截断到不超过处方每日使用量的100%时，平均依从性为50%。年龄较大的儿童和青少年、非白人儿童以及来自功能较差家庭的儿童依从性最低。结论：电子依从性监测明显比自我报告或罐子体重测量更准确。这种准确性是增加对影响依从性的治疗、环境和患者因素的了解以及随后设计有效干预策略的必要前提。
Background: Accurate assessment of medication adherence has been difficult to achieve but is essential to drug evaluation in clinical trials and improved outcomes in clinical care.Objective: This study was conducted to compare four adherence assessment methods: child report, mother report, canister weight, and electronic measurements of metered dose inhaler (MDI) actuation.Methods: Participants included 27 children with mild-to-moderate asthma who were followed prospectively for 6 months. All patients used an MDI equipped with an electronic Doser attached to their inhaled steroid. At each 2-month follow up visit, Doser and canister weight data were recorded, while child and mother were interviewed separately regarding medication use.Results: Children and mothers reported, on average, over 80% adherence with the prescribed inhaled steroid. Canister weight revealed, on average, adherence of 69%, significantly lower than self-report. When adherence recorded by the electronic Doser was truncated to no more than 100% of prescribed daily use, average adherence was 50%. Older children and adolescents, nonwhite children, and these from poorer functioning families were least adherent.Conclusions: Electronic adherence monitoring was significantly more accurate than self-report or canister weight measures. Such accuracy is an essential prerequisite to increasing understanding of the treatment, setting, and patient factors that influence adherence, and to the consequent design of effective intervention strategies.