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实体器官移植受者依从性障碍的临床临界值:多少才算过多?

Clinical cutoffs for adherence barriers in solid organ transplant recipients: how many is too many?

作者信息

Eaton Cyd K, Lee Jennifer L, Simons Laura E, Devine Katie A, Mee Laura L, Blount Ronald L

机构信息

University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine

University of Georgia, Boston Children's Hospital/Harvard Medical School, Rutgers Cancer Institute of New Jersey, and Children's Healthcare of Atlanta/Emory University School of Medicine.

出版信息

J Pediatr Psychol. 2015 May;40(4):431-41. doi: 10.1093/jpepsy/jsu102. Epub 2014 Nov 23.

Abstract

OBJECTIVE

The current study used multiple statistical methods to determine empirically derived and clinically relevant cutoff scores on the Adolescent Medication Barriers Scale (AMBS) and Parent Medication Barriers Scale (PMBS) to detect adolescents and young adults with solid organ transplants who experienced medication nonadherence or negative medical outcomes.

METHODS

Participants included 71 patients and 80 caregivers. Cutoff scores were determined via receiver operating characteristic curve analyses, t-test analyses, and the sensitivity and specificity of using certain cutoff scores.

RESULTS

AMBS scores of ≥3 barriers and PMBS scores of ≥2 barriers were determined as the ideal cutoffs for identifying patients meeting criteria for the outcome variables.

CONCLUSIONS

Clinicians should consider using these recommended cutoff scores when assessing adherence barriers in adolescents and young adults with solid organ transplants and their families. Patients or caregivers endorsing barriers above the cutoffs may benefit from further assessment or intervention to address barriers, nonadherence, or related medical issues.

摘要

目的

本研究采用多种统计方法,以实证得出青少年用药障碍量表(AMBS)和家长用药障碍量表(PMBS)在临床上具有相关性的临界值,用于识别实体器官移植的青少年和青年中存在用药依从性差或不良医疗结局的情况。

方法

参与者包括71名患者和80名照料者。通过受试者工作特征曲线分析、t检验分析以及使用特定临界值的敏感性和特异性来确定临界值。

结果

确定AMBS得分≥3个障碍和PMBS得分≥2个障碍为识别符合结局变量标准患者的理想临界值。

结论

临床医生在评估实体器官移植的青少年和青年及其家庭的依从性障碍时,应考虑使用这些推荐的临界值。认可障碍数高于临界值的患者或照料者可能会受益于进一步评估或干预,以解决障碍、不依从或相关医疗问题。

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