Allocation of Treatment Responsibility in Adolescents With Epilepsy: Associations With Cognitive Skills and Medication Adherence
Allocation of Treatment Responsibility in Adolescents With Epilepsy: Associations With Cognitive Skills and Medication Adherence
复制标题
DOI：
10.1093/jpepsy/jsy006
复制
发表时间：
2019-01-01
影响因子：
3.6
通讯作者：
Modi, Avani C.
中科院分区：
文献类型：
--
作者：
Holbein, Christina E.;Smith, Aimee W.;Modi, Avani C.
目的描述青少年癫痫患者的治疗责任分配（ATR），研究认知技能与ATR之间的关系，并检查抗癫痫药物（aed）的ATR是否预测电子监测的依从性。方法对60例青少年癫痫患者及其照顾者进行治疗责任分配量表和自述量表。病历回顾数据和电子监测AED依从性收集1年。描述性数据评估了照顾者和青少年的ATR；多元层次回归检验了变量之间的关联。结果实验室和诊所预约的ATR对护理人员最大，而aed的ATR更有可能在护理人员和青少年之间共享。较差的注意力与更大的护理人员对aed的责任相关。护理人员对aed的责任越大，12个月内电子监测依从性越高。结论：在青少年癫痫患者中，照顾者负责大部分治疗任务，尽管服用药物的责任由青少年共同承担。更大的护理人员对药物的责任导致更好的长期AED依从性。ATR是一个重要的结构，值得在研究和临床实践中进一步关注，特别是在儿童癫痫的过渡和健康结果的背景下。
Objectives To describe allocation of treatment responsibility (ATR) in adolescents with epilepsy, investigate associations between cognitive skills and ATR, and examine whether ATR for antiepileptic drugs (AEDs) predicted electronically monitored adherence.Method Sixty adolescents with epilepsy and their caregivers completed the Allocation of Treatment Responsibility Scale and a battery of self-report measures. Medical chart review data and electronically monitored AED adherence were collected for 1 year. Descriptive data assessed ATR for caregivers and adolescents; multivariate hierarchical regressions tested associations between variables.Results ATR for labs and clinic appointments was greatest for caregivers, while ATR for AEDs was more likely to be shared between caregiver and adolescent. Poorer attention was associated with greater caregiver responsibility for AEDs. Greater caregiver responsibility for AEDs was associated with higher electronically monitored adherence over 12months.Conclusions In adolescents with epilepsy, caregivers are responsible for most treatment tasks, although responsibility for taking medication was shared with the adolescent. Greater caregiver responsibility for medication results in better long-term AED adherence. ATR is an important construct that warrants further attention in research and clinical practice, especially in the context of transition and health outcomes in pediatric epilepsy.