Mehta Pooja, Steinberg Elizabeth A, Kelly Sarah L, Buchanan Cindy, Rawlinson Alana Resmini
Digestive Health Institute, Children's Hospital Colorado, Section of Pediatric Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, USA.
Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA.
Pediatr Transplant. 2017 Nov;21(7). doi: 10.1111/petr.13018. Epub 2017 Jul 2.
The aim of this study was to assess healthcare provider perspectives on barriers to medication adherence and to discover recommendations for interventions among providers of pediatric solid-organ transplant patients. An anonymous online survey was administered to a multidisciplinary pool of pediatric transplant providers from February 2015 to March 2016. It consisted of 15 questions regarding transplant providers' attitudes, clinical practice, and beliefs pertaining to medication adherence among teenage solid-organ transplant recipients. Data were analyzed using descriptive statistics. Responses to open-ended questions were coded and categorized into themes. One hundred ten surveys were completed by providers specializing in pediatric heart, kidney, liver, lung, and/or intestinal transplantation. Commonly cited reasons for poor adherence were forgetting/poor planning (94%), the desire to be normal (86%), lack of support (86%), and poor parental monitoring (79%). Suggestions to improve adherence included increasing peer and family support, providing education, and incorporating technology into adherence regimens. Barriers to adherence in transplant patients are recognized by providers and are both similar to and disparate from patient and family identified barriers published in the literature. Providers recognize the importance of education, social support, and technologically driven interventions on improving outcomes in the transplant population.
本研究的目的是评估医疗服务提供者对药物依从性障碍的看法，并探索针对小儿实体器官移植患者医疗服务提供者的干预建议。2015年2月至2016年3月，对多学科的小儿移植医疗服务提供者进行了一项匿名在线调查。该调查包含15个问题，涉及移植医疗服务提供者对青少年实体器官移植受者药物依从性的态度、临床实践和信念。使用描述性统计方法对数据进行分析。对开放式问题的回答进行编码并归类为主题。专门从事小儿心脏、肾脏、肝脏、肺和/或肠道移植的医疗服务提供者共完成了110份调查问卷。依从性差的常见原因包括遗忘/计划不周（94%）、渴望正常（86%）、缺乏支持（86%）和家长监督不力（79%）。改善依从性的建议包括增加同伴和家庭支持、提供教育以及将技术纳入依从性方案。移植患者的依从性障碍已得到医疗服务提供者的认可，这些障碍与文献中患者及家属所指出的障碍既有相似之处，也有不同之处。医疗服务提供者认识到教育、社会支持和技术驱动的干预措施对改善移植人群治疗效果的重要性。
