基于实践的儿科治疗方案依从性评估与治疗方法
Practice-Based Approach to Assessing and Treating Non-Adherence in Pediatric Regimens.
作者信息
Duncan Christina L, Mentrikoski Janelle M, Wu Yelena P, Fredericks Emily M
机构信息
West Virginia University, Department of Psychology.
University of Utah, Department of Family and Preventive Medicine.
出版信息
Clin Pract Pediatr Psychol. 2014 Sep;2(3):322-336. doi: 10.1037/cpp0000066.
With advances in medical care, youth with chronic illness have the potential for higher quality of life; however, these treatments often come with cost (i.e., burden, financial) that can result in non-adherence. Pediatric non-adherence, on average, is approximately 50% across chronic health conditions. Research has identified effective, evidence-based assessment measures and intervention strategies to promote regimen adherence in youth. Yet, these measures and strategies typically are designed for clinical trials and thus may not be feasible or practical in typical clinic settings. As the field of adherence assessment and intervention expands, it will be important to devise evidence-based tools that are pragmatic and can be translated easily into practice. To guide this future direction, the goals of this paper are to review evidence-based adherence assessment and intervention strategies that can be used with youth and families in clinical practice, to illustrate the complexities of addressing adherence concerns in routine practice, and to discuss the challenges of disseminating and implementing evidence-based strategies in the real world.
随着医疗护理的进步，患有慢性病的青少年有可能拥有更高的生活质量；然而，这些治疗往往伴随着成本（即负担、经济方面），这可能导致治疗依从性不佳。平均而言，儿科患者在各种慢性健康状况下的治疗不依从率约为50%。研究已经确定了有效、基于证据的评估措施和干预策略，以促进青少年的治疗方案依从性。然而，这些措施和策略通常是为临床试验设计的，因此在典型的临床环境中可能不可行或不实用。随着依从性评估和干预领域的扩大，设计出实用且能轻松转化为实践的基于证据的工具将很重要。为了指导这一未来方向，本文的目标是回顾可在临床实践中与青少年及其家庭一起使用的基于证据的依从性评估和干预策略，说明在常规实践中解决依从性问题的复杂性，并讨论在现实世界中传播和实施基于证据的策略所面临的挑战。
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