药物治疗依从性与囊性纤维化患者肺部健康的纵向关联。
Longitudinal association between medication adherence and lung health in people with cystic fibrosis.
机构信息
Division of Pulmonary and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21224, USA.
出版信息
J Cyst Fibros. 2011 Jul;10(4):258-64. doi: 10.1016/j.jcf.2011.03.005. Epub 2011 Mar 31.
Abstract
BACKGROUND
This study examined the relationship of medication adherence to frequency of pulmonary exacerbation and rate of decline in FEV(1)% predicted (FEV(1)).
METHODS
95 CF patients aged 6 years or older and prescribed a pulmonary medication, were enrolled in a longitudinal retrospective review of medication adherence and health outcomes (the occurrence and frequency of intravenous (IV) antibiotic treatments and FEV(1)) over 12-months. Pharmacy refill records were used to calculate a medication possession ratio (MPR).
RESULTS
Composite MPR predicted the occurrence of at least one pulmonary exacerbation requiring a course of IV antibiotics (IRR=2.34, p=0.05), but not the frequency of exacerbations, after controlling for gender, baseline FEV(1,) and regimen complexity. Composite MPR predicted baseline FEV(1) (estimate=29.81, p=.007), but not decline in FEV(1).
CONCLUSIONS
These results demonstrate a significant relation between medication adherence and IV antibiotics in CF patients, highlighting the importance of addressing adherence during clinic visits to improve health outcomes.
摘要
背景
本研究旨在探讨药物依从性与肺部恶化频率和 FEV(1)%预计值（FEV(1)）下降率之间的关系。
方法
95 名年龄在 6 岁及以上且接受肺部药物治疗的 CF 患者，参与了一项关于药物依从性和健康结果（静脉（IV）抗生素治疗的发生和频率以及 FEV(1)）的 12 个月纵向回顾性研究。使用药房补充记录来计算药物持有率（MPR）。
结果
复合 MPR 可预测至少一次需要 IV 抗生素治疗的肺部恶化（IRR=2.34，p=0.05），但在控制性别、基线 FEV(1)和方案复杂性后，不能预测恶化的频率。复合 MPR 可预测基线 FEV(1)（估计值=29.81，p=.007），但不能预测 FEV(1)的下降。
结论
这些结果表明 CF 患者的药物依从性与 IV 抗生素之间存在显著关系，强调了在就诊期间解决依从性问题以改善健康结果的重要性。
相似文献
1
Longitudinal association between medication adherence and lung health in people with cystic fibrosis.药物治疗依从性与囊性纤维化患者肺部健康的纵向关联。
J Cyst Fibros. 2011 Jul;10(4):258-64. doi: 10.1016/j.jcf.2011.03.005. Epub 2011 Mar 31.
2
Oral Azithromycin Use and the Recovery of Lung Function from Pulmonary Exacerbations Treated with Intravenous Tobramycin or Colistimethate in Adults with Cystic Fibrosis.口服阿奇霉素治疗与静脉用妥布霉素或黏菌素治疗对囊性纤维化成人肺部恶化后肺功能恢复的影响。
Ann Am Thorac Soc. 2019 Jul;16(7):853-860. doi: 10.1513/AnnalsATS.201811-773OC.
3
Oral Azithromycin and Response to Pulmonary Exacerbations Treated with Intravenous Tobramycin in Children with Cystic Fibrosis.口服阿奇霉素和静脉注射妥布霉素治疗囊性纤维化儿童肺部恶化的反应。
Ann Am Thorac Soc. 2019 Jul;16(7):861-867. doi: 10.1513/AnnalsATS.201811-774OC.
4
Failure to recover to baseline pulmonary function after cystic fibrosis pulmonary exacerbation.囊性纤维化肺部恶化后未能恢复到基线肺功能。
Am J Respir Crit Care Med. 2010 Sep 1;182(5):627-32. doi: 10.1164/rccm.200909-1421OC. Epub 2010 May 12.
5
Return of FEV1 after pulmonary exacerbation in children with cystic fibrosis.肺囊泡纤维化患儿肺部恶化后 FEV1 的恢复情况。
Pediatr Pulmonol. 2010 Feb;45(2):127-34. doi: 10.1002/ppul.21117.
6
Improving evidence-based care in cystic fibrosis through quality improvement.通过质量改进提高囊性纤维化的循证医疗水平。
Arch Pediatr Adolesc Med. 2010 Oct;164(10):957-60. doi: 10.1001/archpediatrics.2010.178.
7
Location and duration of treatment of cystic fibrosis respiratory exacerbations do not affect outcomes.囊性纤维化呼吸加重症的治疗位置和持续时间并不影响治疗结果。
Am J Respir Crit Care Med. 2010 Nov 1;182(9):1137-43. doi: 10.1164/rccm.201001-0057OC. Epub 2010 Jun 25.
8
Tobramycin inhalation powder manufactured by improved process in cystic fibrosis: the randomized EDIT trial.采用改良工艺制备的妥布霉素吸入粉在囊性纤维化中的随机 EDIT 试验。
Curr Med Res Opin. 2013 Aug;29(8):947-56. doi: 10.1185/03007995.2013.805122. Epub 2013 Jun 5.
9
Long term clinical outcome of home and hospital intravenous antibiotic treatment in adults with cystic fibrosis.成年囊性纤维化患者家庭与医院静脉注射抗生素治疗的长期临床结果
Thorax. 2004 Mar;59(3):242-6. doi: 10.1136/thx.2003.005876.
10
Clinical use of dornase alpha is associated with a slower rate of FEV1 decline in cystic fibrosis.α-糜蛋白酶在临床上的应用与囊性纤维化患者的 FEV1 下降率较慢有关。
Pediatr Pulmonol. 2011 Jun;46(6):545-53. doi: 10.1002/ppul.21388. Epub 2011 Mar 24.
引用本文的文献
1
Associations Between Socioeconomic Status and Adherence to Medications in People With Cystic Fibrosis.囊性纤维化患者的社会经济地位与药物依从性之间的关联
Pediatr Pulmonol. 2025 Aug;60(8):e71230. doi: 10.1002/ppul.71230.
2
Using Community Engagement to Create a Telecoaching Intervention to Improve Self-Management in Adolescents and Young Adults With Cystic Fibrosis: Qualitative Study.利用社区参与创建远程辅导干预措施以改善青少年和青年囊性纤维化患者的自我管理：定性研究
J Particip Med. 2025 Jan 20;17:e49941. doi: 10.2196/49941.
3
A real-world analysis of pharmacotherapy adherence and the factors influencing it in Serbia: a nationwide, population-based, cross-sectional study.塞尔维亚真实世界药物治疗依从性及其影响因素的分析：一项全国性、基于人群的、横断面研究。
Front Public Health. 2024 Aug 1;12:1437796. doi: 10.3389/fpubh.2024.1437796. eCollection 2024.
4
Cross-Cutting mHealth Behavior Change Techniques to Support Treatment Adherence and Self-Management of Complex Medical Conditions: Systematic Review.交叉切割移动健康行为改变技术以支持复杂医疗状况的治疗依从性和自我管理：系统评价。
JMIR Mhealth Uhealth. 2024 May 1;12:e49024. doi: 10.2196/49024.
5
Interchanging Reusable and Disposable Nebulizers Used with Home-Based Compressors May Result in Inconsistent Dosing: A Laboratory Investigation with Device Combinations Supplied to the US Healthcare Environment.在家用压缩机上互换使用可重复使用和一次性雾化器可能导致给药剂量不一致：对供应给美国医疗环境的设备组合进行的实验室调查。
Pulm Ther. 2024 Jun;10(2):207-224. doi: 10.1007/s41030-024-00256-0. Epub 2024 Apr 15.
6
Perceived burden of respiratory physiotherapy in people with cystic fibrosis taking elexacaftor-tezacaftor-ivacaftor combination: a 1-year observational study.囊性纤维化患者使用依利卓艾卡托替卡那三联组合治疗的呼吸物理治疗感知负担：一项为期 1 年的观察性研究。
Ther Adv Respir Dis. 2024 Jan-Dec;18:17534666241235054. doi: 10.1177/17534666241235054.
7
Treatable traits and challenges in the clinical management of non-tuberculous mycobacteria lung disease in people with cystic fibrosis.囊性纤维化患者中非结核分枝杆菌肺病的临床管理中可治疗的特征和挑战。
Respir Res. 2023 Dec 16;24(1):316. doi: 10.1186/s12931-023-02612-1.
8
Aiming to Improve Equity in Pulmonary Health: Cystic Fibrosis.旨在改善肺部健康公平性：囊性纤维化。
Clin Chest Med. 2023 Sep;44(3):555-573. doi: 10.1016/j.ccm.2023.03.011. Epub 2023 May 8.
9
Interventions for improving adherence to airway clearance treatment and exercise in people with cystic fibrosis.改善囊性纤维化患者气道清除治疗和运动依从性的干预措施。
Cochrane Database Syst Rev. 2023 Jul 18;7(7):CD013610. doi: 10.1002/14651858.CD013610.pub2.
10
Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis.心理干预对改善囊性纤维化患者吸入治疗依从性的作用。
Cochrane Database Syst Rev. 2023 Mar 29;3(3):CD013766. doi: 10.1002/14651858.CD013766.pub2.
本文引用的文献
1
Accurate assessment of adherence: self-report and clinician report vs electronic monitoring of nebulizers.准确评估依从性：自我报告和临床医生报告与雾化器电子监测的比较。
Chest. 2011 Aug;140(2):425-432. doi: 10.1378/chest.09-3074. Epub 2011 Feb 17.
2
Perceptions of barriers and facilitators: self-management decisions by older adolescents and adults with CF.老年人和成年人 CF 自我管理决策的障碍和促进因素的认知。
J Cyst Fibros. 2010 Dec;9(6):425-32. doi: 10.1016/j.jcf.2010.08.016. Epub 2010 Sep 16.
3
Design and powering of cystic fibrosis clinical trials using rate of FEV(1) decline as an efficacy endpoint.以 FEV1 下降率作为疗效终点的囊性纤维化临床试验的设计和实施。
J Cyst Fibros. 2010 Sep;9(5):332-8. doi: 10.1016/j.jcf.2010.05.004. Epub 2010 Jun 19.
4
Association between respiratory tract methicillin-resistant Staphylococcus aureus and survival in cystic fibrosis.呼吸道耐甲氧西林金黄色葡萄球菌与囊性纤维化患者生存的关系。
JAMA. 2010 Jun 16;303(23):2386-92. doi: 10.1001/jama.2010.791.
5
Influenza-associated cystic fibrosis pulmonary exacerbations.流感相关性囊性纤维化肺部恶化。
Chest. 2010 Apr;137(4):852-60. doi: 10.1378/chest.09-1374. Epub 2009 Dec 4.
6
Adherence to combined montelukast and fluticasone treatment in economically disadvantaged african american youth with asthma.经济条件不利的非裔美国哮喘青少年对孟鲁司特和氟替卡松联合治疗的依从性。
J Asthma. 2009 Nov;46(9):921-7. doi: 10.3109/02770900903229651.
7
Association of socioeconomic status with the use of chronic therapies and healthcare utilization in children with cystic fibrosis.社会经济地位与囊性纤维化患儿慢性治疗的使用及医疗保健利用的关联
J Pediatr. 2009 Nov;155(5):634-9.e1-4. doi: 10.1016/j.jpeds.2009.04.059. Epub 2009 Jul 16.
8
Improvements in lung function outcomes in children with cystic fibrosis are associated with better nutrition, fewer chronic pseudomonas aeruginosa infections, and dornase alfa use.囊性纤维化患儿肺功能结果的改善与更好的营养状况、更少的慢性铜绿假单胞菌感染以及使用多黏菌素B有关。
J Pediatr. 2008 Dec;153(6):752-7. doi: 10.1016/j.jpeds.2008.07.011. Epub 2008 Aug 29.
9
Negative affect, medication adherence, and asthma control in children.儿童的消极情绪、药物依从性与哮喘控制
J Allergy Clin Immunol. 2008 Sep;122(3):490-5. doi: 10.1016/j.jaci.2008.05.041. Epub 2008 Jul 7.
10
Cystic fibrosis pulmonary guidelines: chronic medications for maintenance of lung health.囊性纤维化肺部指南：维持肺部健康的慢性药物治疗
Am J Respir Crit Care Med. 2007 Nov 15;176(10):957-69. doi: 10.1164/rccm.200705-664OC. Epub 2007 Aug 29.
Zotero 插件