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电子监测和反馈以提高儿童哮喘的依从性。

Electronic monitoring and feedback to improve adherence in pediatric asthma.

机构信息

Department of Psychology, West Virginia University, Morgantown, WV 26506, USA.

出版信息

J Pediatr Psychol. 2012 Jan-Feb;37(1):64-74. doi: 10.1093/jpepsy/jsr059. Epub 2011 Aug 18.

DOI:10.1093/jpepsy/jsr059
PMID:21852340
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3935003/
Abstract

OBJECTIVE

To evaluate the effectiveness of electronic monitoring and feedback to improve adherence in children taking daily asthma controller medications.

METHOD

Five patients with asthma and considered nonadherent participated. Inhalers were electronically monitored with the MDILogII(TM) device, and feedback was given by medical staff. Using a nonconcurrent multiple-baseline design, patients and their parents received bimonthly feedback regarding medication use. Following treatment, feedback was withdrawn and effects of monitoring alone were observed.

RESULTS

Three participants showed improvements in adherence following treatment, with more notable increases when baseline adherence was low. Improvements in the inhaler technique occurred for all patients. Some patients demonstrated improvements in lung functioning and functional severity. When feedback was withdrawn, adherence decreased for some participants, but technique improvements maintained.

CONCLUSIONS

Results support the use of objective monitoring devices for assessing pediatric asthma patients' adherence and indicate that feedback from medical staff may improve and maintain medication adherence for some patients.

摘要

目的

评估电子监测和反馈对提高每日哮喘控制药物服用依从性的效果。

方法

5 名被认为不依从的哮喘患儿参与了研究。采用 MDILogII(TM)设备对吸入器进行电子监测,并由医务人员提供反馈。采用非同期多项基线设计,患者及其父母每月接受两次关于药物使用的反馈。治疗结束后,停止反馈,观察仅监测的效果。

结果

3 名参与者在治疗后依从性得到改善,基线依从性较低时改善更明显。所有患者的吸入技术都有所提高。一些患者的肺功能和功能严重程度得到改善。当停止反馈时,一些参与者的依从性下降,但技术改进仍在维持。

结论

研究结果支持使用客观监测设备评估儿科哮喘患者的依从性,并表明医务人员的反馈可能会提高和维持一些患者的药物依从性。

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本文引用的文献

1
Treatment adherence among low-income, African American children with persistent asthma.低收入非裔美国裔持续性哮喘儿童的治疗依从性
J Asthma. 2010 Apr;47(3):317-22. doi: 10.3109/02770900903580850.
2
Providing feedback on adherence increases use of preventive medication by asthmatic children.就依从性提供反馈可提高哮喘儿童预防性药物的使用。
J Asthma. 2010 Mar;47(2):198-201. doi: 10.3109/02770900903483840.
3
Adherence to pediatric asthma treatment in economically disadvantaged African-American children and adolescents: an application of growth curve analysis.经济条件不利的非裔美国儿童和青少年对儿童哮喘治疗的坚持情况:增长曲线分析的应用。
J Pediatr Psychol. 2010 May;35(4):394-404. doi: 10.1093/jpepsy/jsp074. Epub 2009 Aug 26.
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How to select, calculate, and interpret effect sizes.如何选择、计算和解释效应量。
J Pediatr Psychol. 2009 Oct;34(9):917-28. doi: 10.1093/jpepsy/jsp004. Epub 2009 Feb 16.
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Evidence-based assessment of adherence to medical treatments in pediatric psychology.儿科心理学中基于证据的药物治疗依从性评估
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Testing an intervention to promote children's adherence to asthma self-management.测试一项促进儿童坚持哮喘自我管理的干预措施。
J Nurs Scholarsh. 2007;39(2):133-40. doi: 10.1111/j.1547-5069.2007.00158.x.
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Assessment of inhalation technique and determinants of incorrect performance among children with asthma.哮喘儿童吸入技术评估及吸入操作错误的影响因素
Pediatr Pulmonol. 2006 Nov;41(11):1082-7. doi: 10.1002/ppul.20498.
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Patterns of quick-relief and long-term controller medication use in pediatric asthma.儿童哮喘快速缓解药物和长期控制药物的使用模式
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Medication adherence in pediatric asthma: reasoning, responsibility, and behavior.儿童哮喘的药物依从性:推理、责任和行为。
J Pediatr Psychol. 2003 Jul-Aug;28(5):323-33. doi: 10.1093/jpepsy/jsg022.
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Enhancing medication adherence among inner-city children with asthma: results from pilot studies.提高市中心哮喘儿童的药物依从性:试点研究结果。
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