Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
J Pediatr Psychol. 2019 Jan 1;44(1):72-83. doi: 10.1093/jpepsy/jsy006.
To describe allocation of treatment responsibility (ATR) in adolescents with epilepsy, investigate associations between cognitive skills and ATR, and examine whether ATR for antiepileptic drugs (AEDs) predicted electronically monitored adherence.
Sixty adolescents with epilepsy and their caregivers completed the Allocation of Treatment Responsibility Scale and a battery of self-report measures. Medical chart review data and electronically monitored AED adherence were collected for 1 year. Descriptive data assessed ATR for caregivers and adolescents; multivariate hierarchical regressions tested associations between variables.
ATR for labs and clinic appointments was greatest for caregivers, while ATR for AEDs was more likely to be shared between caregiver and adolescent. Poorer attention was associated with greater caregiver responsibility for AEDs. Greater caregiver responsibility for AEDs was associated with higher electronically monitored adherence over 12 months.
In adolescents with epilepsy, caregivers are responsible for most treatment tasks, although responsibility for taking medication was shared with the adolescent. Greater caregiver responsibility for medication results in better long-term AED adherence. ATR is an important construct that warrants further attention in research and clinical practice, especially in the context of transition and health outcomes in pediatric epilepsy.
描述青少年癫痫患者的治疗责任分配（ATR），研究认知技能与 ATR 的相关性，并检验抗癫痫药物（AED）的 ATR 是否预测电子监测的依从性。
60 名青少年癫痫患者及其照顾者完成了治疗责任分配量表和一系列自我报告量表。收集了 1 年的医疗记录和电子监测的 AED 依从性数据。描述性数据评估了照顾者和青少年的 ATR；多元层次回归检验了变量之间的相关性。
照顾者最有可能负责实验室和诊所的预约，而 AED 的 ATR 更有可能在照顾者和青少年之间共享。注意力越差，照顾者对 AED 的责任就越大。照顾者对 AED 的责任越大，12 个月内电子监测的依从性就越高。
在青少年癫痫患者中，大多数治疗任务由照顾者负责，尽管照顾者和青少年共同负责服药。照顾者对药物的责任越大，AED 的长期依从性就越好。ATR 是一个重要的结构，值得在研究和临床实践中进一步关注，特别是在儿科癫痫的过渡和健康结果方面。
