Influence of Parental Health Literacy and Dosing Responsibility on Pediatric Glaucoma Medication Adherence
Influence of Parental Health Literacy and Dosing Responsibility on Pediatric Glaucoma Medication Adherence
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DOI：
10.1001/archopthalmol.2011.1788
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发表时间：
2012-03-01
影响因子：
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通讯作者：
Muir, Kelly W.
中科院分区：
文献类型：
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作者：
Freedman, Rebecca B.;Jones, Sarah K.;Muir, Kelly W.
目的：评估儿童青光眼用药依从性，假设父母健康素养差和儿童滴眼液与依从性差有关。方法：这项前瞻性观察性研究纳入了青光眼儿童患者，他们服用了眼药水。家长(S)报告了谁负责滴眼(家长与孩子)，参加了成人医学素养快速评估，并接受了药物事件监测系统的使用和目的的指导。计算包括平均依从性(服用处方剂量的比例)、给药错误(24小时内过量或剂量不足事件的数量)和按计划服用的剂量比例(在规定剂量间隔2小时内服用)。结果：这项研究包括50名使用药物事件监测系统30天或更长时间的登记儿童中的46名。依从性在43%~107%之间(93%[12%])，与年龄无关(斜率，0.09[0.52]；P=.86)，但随父母健康素养降低而下降(斜率，0.62[0.24]；P=0.01)。每天开药与每天开两次药的平均剂量错误数相似(3.3对2.9；P=.66)。按计划(在规定剂量间隔的2小时内)服药的比例为3%~97%(中位数为34%；平均为41%[24%])，父母滴眼液与孩子滴眼液的比例更好(46%[26%]对23%[19%]；P
Objective: To assess glaucoma medication adherence in children, hypothesizing that poor parental health literacy and eye drop instillation by the child are associated with worse adherence.Methods: This prospective, observational study enrolled pediatric patients with glaucoma who were prescribed eye drops. Parent(s) reported who was responsible for eye drop instillation (parent vs child), took the Rapid Estimate of Adult Literacy in Medicine, and were instructed on the use and purpose of the Medication Event Monitoring System. Calculations included average adherence (proportion of prescribed doses taken), dosing errors (number of overdosing or underdosing events in 24 hours), and proportion of doses taken on schedule (doses taken within 2 hours of prescribed dosing interval). Results are reported as mean (SD) or median.Results: The study included 46 of the 50 enrolled children who used the Medication Event Monitoring System for 30 days or more. Adherence ranged from 43% to 107% (93%[12%]) and was not associated with age (slope, 0.09 [0.52]; P=.86) but decreased with the parent's lower health literacy (slope, 0.62 [0.24]; P=.01). The mean number of dosing errors for medications prescribed daily vs twice daily was similar (3.3 vs 2.9; P=.66). The proportion of doses taken on schedule (within 2 hours of prescribed dosing interval) ranged from 3% to 97% (median, 34%; mean, 41%[24%]) and was better when the parent vs the child instilled eye drops (46% [26%] vs 23% [19%]; P