儿童炎症性肠病的药物依从性与生活质量
Medication adherence and quality of life in pediatric inflammatory bowel disease.
作者信息
Hommel Kevin A, Davis Christine M, Baldassano Robert N
机构信息
Cincinnati Children's Hospital Medical Center, Center for the Promotion of Treatment Adherence and Self Management, Division of Behavioral Medicine and Clinical Psychology, 3333 Burnet Ave. MLC 7039, Cincinnati, OH 45229, USA.
出版信息
J Pediatr Psychol. 2008 Sep;33(8):867-74. doi: 10.1093/jpepsy/jsn022. Epub 2008 Mar 11.
OBJECTIVE
To examine the relationship between medication adherence and quality of life (QOL) in adolescent patients with inflammatory bowel disease (IBD) utilizing a multimethod adherence assessment approach.
METHODS
Medication adherence in 36 adolescents with IBD was assessed via interviews, pill counts, and biological assays. QOL was assessed via patient and parent report. Pediatric gastroenterologists provided disease severity assessments.
RESULTS
Hierarchical multiple regression analyses revealed that adherence contributed significant variance to patient-reported QOL but not parent-reported QOL. Nonadherence to 6-MP/azathioprine was related to poorer patient-reported physical health QOL. Greater self-reported 5-ASA adherence was related to poorer overall psychological health QOL, and particularly social functioning QOL.
CONCLUSIONS
Results provide preliminary support for the negative effects of 6-MP/azathioprine nonadherence on QOL and an inverse relationship between 5-ASA adherence and QOL in this population. Adherence burden in patients and the utility of multimethod adherence assessment in research are discussed.
目的
采用多方法依从性评估方法，研究炎症性肠病（IBD）青少年患者的药物依从性与生活质量（QOL）之间的关系。
方法
通过访谈、药片计数和生物学检测评估36例IBD青少年患者的药物依从性。通过患者和家长报告评估生活质量。儿科胃肠病学家提供疾病严重程度评估。
结果
分层多元回归分析显示，依从性对患者报告的生活质量有显著差异，但对家长报告的生活质量无显著差异。不依从6-巯基嘌呤/硫唑嘌呤与患者报告的较差的身体健康生活质量相关。自我报告的5-氨基水杨酸依从性越高，总体心理健康生活质量越差，尤其是社会功能生活质量。
结论
结果为不依从6-巯基嘌呤/硫唑嘌呤对生活质量的负面影响以及该人群中5-氨基水杨酸依从性与生活质量之间的负相关关系提供了初步支持。讨论了患者的依从负担以及多方法依从性评估在研究中的效用。
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