Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
J Pediatr. 2012 Oct;161(4):695-9.e1. doi: 10.1016/j.jpeds.2012.03.059. Epub 2012 May 18.
To examine white coat adherence over time in children with epilepsy.
This was a longitudinal prospective study to examine medication adherence prior to and following consecutive clinic visits over a 13-month period in 120 children with newly diagnosed epilepsy (M(age) = 7.2 ± 2.9 years; 38% female) and their caregivers. Electronic monitors were used to assess adherence and ordinal logistic regression models were employed.
Results demonstrated white coat adherence, with adherence increasing during the 3 days preceding clinic visits. Data also revealed a significant interaction, whereby adherence increased following initial clinic visits, but decreased following the last clinic visit.
White coat adherence occurs for children with newly diagnosed epilepsy. Increased awareness of white coat adherence has important implications for clinical decision-making and should be examined in other pediatric populations. Increased monitoring of medication patterns can help clinicians avoid unnecessary changes to the treatment regimen. Interventions targeting improved communication around adherence behaviors are necessary to maximize therapy benefits.
考察癫痫患儿随时间推移的“白大衣依从性”。
这是一项纵向前瞻性研究,在 120 名新诊断为癫痫的儿童(M(年龄)= 7.2 ± 2.9 岁;38%为女性)及其照顾者的 13 个月期间,连续门诊就诊前后,使用电子监测器来评估依从性,并采用有序逻辑回归模型进行分析。
结果表明存在“白大衣依从性”,即在门诊就诊前的 3 天内依从性增加。数据还显示出显著的交互作用,即首次门诊就诊后依从性增加,但最后一次门诊就诊后依从性下降。
新诊断为癫痫的儿童存在“白大衣依从性”。对“白大衣依从性”的认识增加对临床决策具有重要意义,应在其他儿科人群中进行研究。增加对药物模式的监测有助于临床医生避免对治疗方案进行不必要的更改。有必要针对改善围绕依从性行为的沟通进行干预,以最大限度地提高治疗效果。