简要报告：小儿炎症性肠病治疗依从性的障碍。
Brief report: Barriers to treatment adherence in pediatric inflammatory bowel disease.
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, Cincinnati, OH 45229-3039, USA.
出版信息
J Pediatr Psychol. 2010 Oct;35(9):1005-10. doi: 10.1093/jpepsy/jsp126. Epub 2009 Dec 21.
OBJECTIVE
To examine perceived barriers to medication adherence in inflammatory bowel disease (IBD) treatment and their relationship with adherence using a combined forced choice and semi-structured interview assessment approach.
METHODS
Sixteen adolescents with IBD and their parents participated in an open-ended interview regarding adherence barriers and completed quantitative measures of adherence, barriers to treatment, and disease severity.
RESULTS
The most commonly identified barriers to adherence were forgetting, interference with other activities, difficulty swallowing pills, and not being at home. Number of reported barriers was positively correlated with objective nonadherence for 6-MP/azathioprine. Nonadherence frequency was 42% for 6-MP/azathoprine and 50% for 5-ASA medications.
CONCLUSIONS
Using a combined assessment approach, patients and parents reported several barriers to treatment adherence that are appropriate for clinical intervention. This is critical given the significant medication nonadherence observed in this sample and the relationship between total number of barriers and disease management problems.
目的
采用强制选择与半结构化访谈评估相结合的方法，考察炎症性肠病（IBD）治疗中患者对药物治疗依从性的认知障碍及其与依从性的关系。
方法
16 名 IBD 青少年及其父母参与了一项关于依从性障碍的开放性访谈，并完成了依从性、治疗障碍和疾病严重程度的定量评估。
结果
最常见的依从性障碍包括遗忘、与其他活动的冲突、难以吞咽药片以及不在家。报告的障碍数量与巯嘌呤/硫唑嘌呤的客观不依从呈正相关。巯嘌呤/硫唑嘌呤的不依从频率为 42%，5-ASA 药物的不依从频率为 50%。
结论
采用联合评估方法，患者和家长报告了几种治疗依从性障碍，这些障碍适合临床干预。鉴于该样本中观察到的显著药物不依从性以及总障碍数量与疾病管理问题之间的关系，这一点至关重要。
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