Medical College of Wisconsin, Department of Pediatrics, Division of Pediatric Gastroenterology and Nutrition, Milwaukee, Wisconsin 53226, USA.
Inflamm Bowel Dis. 2010 Jan;16(1):36-41. doi: 10.1002/ibd.20988.
The purpose of this study was to describe barriers to adherence among adolescents with inflammatory bowel disease (IBD) and to examine demographic, disease-related, and treatment regimen-related correlates of adherence barriers using a multimethod reporting strategy. A final goal was to examine relationships between the frequencies of barriers and levels of nonadherence.
In all, 64 adolescents (ages 11-18) participated, along with 61 mothers and 25 fathers. Barriers to adherence and ratings of medication adherence were assessed via patient and parent reports. Disease activity ratings were provided by pediatric gastroenterologists.
Lack of time and medication side effects were commonly reported barriers across adolescent, mother, and father reports. Other adolescent-reported barriers included missing medication due to feeling well or discontinuing medication based on the belief that the medication was not working. The prevalence of adherence barriers was not consistently associated with adolescent age, sex, time since diagnosis, or disease activity. Adolescents whose regimen involved more than 1 daily medication administration had more adherence barriers based on adolescent and maternal report than did those whose regimen involved 1 or less than 1 daily medication administration. Finally, adherence barriers were significantly higher among families reporting imperfect adherence as compared to those reporting perfect adherence.
Barriers to medication adherence do exist among adolescents with IBD and may have negative implications for medication adherence. Systematic assessment of barriers during routine medical appointments may help to identify and modify these barriers and ultimately improve adherence.
本研究旨在描述炎症性肠病（IBD）青少年患者在坚持治疗方面存在的障碍，并采用多方法报告策略，研究与人口统计学、疾病相关及治疗方案相关的与坚持治疗障碍相关的因素。最终目标是研究障碍发生频率与非坚持治疗水平之间的关系。
共有 64 名（年龄 11-18 岁）青少年、61 名母亲和 25 名父亲参与了本研究。通过患者和家长报告，评估坚持治疗的障碍和药物坚持治疗的评分。儿科胃肠病学家提供疾病活动评分。
缺乏时间和药物副作用是青少年、母亲和父亲报告中常见的坚持治疗障碍。其他青少年报告的障碍包括因感觉良好而漏服药物或因认为药物无效而停止用药。坚持治疗障碍的发生率与青少年年龄、性别、诊断后时间或疾病活动无一致关联。与每天服用 1 种或少于 1 种药物的方案相比，每天服用 1 种以上药物的方案的青少年和母亲报告的坚持治疗障碍更多。最后，与报告完全坚持治疗的家庭相比，报告不完美坚持治疗的家庭的坚持治疗障碍更高。
IBD 青少年确实存在药物坚持治疗障碍，这可能对药物坚持治疗产生负面影响。在常规医疗预约中系统评估障碍，可能有助于识别和纠正这些障碍，并最终改善坚持治疗。
