Pediatric Pulmonology, Michigan Medicine, Ann Arbor, Michigan.
Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan.
Pediatr Pulmonol. 2018 Apr;53(4):431-436. doi: 10.1002/ppul.23950. Epub 2018 Feb 19.
Medication adherence among adolescents with cystic fibrosis (CF) is often suboptimal and this has significant impact on their health and quality of life. The purpose of the study was to evaluate the impact of frequent home pulmonary function (PFT) monitoring on medication adherence among adolescents with CF.
We hypothesized that weekly home PFT monitoring will improve adherence while not significantly adding to the treatment burden.
Individuals aged 12-21 years with CF were provided a spirometer to measure PFTs weekly for 1 year. Results were reviewed weekly via telephone. PFT data were downloaded from the device during quarterly clinic visits. Adherence was calculated from prescription refill data and compared to the previous year. Perceptions of treatment burden were assessed using the CF questionnaire-revised (CFQ-R) quality of life measure. Health outcome measures including nutritional status and PFTs from clinic were collected for the study period and the year prior.
Thirty-nine subjects participated in the study. Mean age was 15.89 ± 2.18 years and 54% were female. Mean adherence to weekly spirometry monitoring was 59.47 ± 24.60%. Values generated on the device showed good correlation with those obtained in clinic. Mean medication possession ratio (MPR) was 60% in the previous year and 65% during the study (P = 0.04). Mean treatment burden scaled score on the CFQ-R was 68 at enrollment and 66 at study completion (P = 0.14).
Frequent home PFT monitoring is feasible in CF adolescents and could successfully improve medication adherence without significantly impacting treatment burden.
青少年囊性纤维化（CF）患者的药物依从性往往不理想，这对他们的健康和生活质量有重大影响。本研究的目的是评估频繁家庭肺功能（PFT）监测对 CF 青少年药物依从性的影响。
我们假设每周家庭 PFT 监测将改善依从性，而不会显著增加治疗负担。
12-21 岁的 CF 患者被提供肺活量计，以每周测量一次 PFT，为期一年。结果通过电话每周进行回顾。每季度就诊时从设备中下载 PFT 数据。从处方补充数据中计算依从性，并与前一年进行比较。使用 CF 问卷修订版（CFQ-R）生活质量测量来评估治疗负担的认知。在研究期间和前一年收集了健康结果测量，包括营养状况和来自诊所的 PFT。
39 名受试者参与了这项研究。平均年龄为 15.89±2.18 岁，54%为女性。每周进行肺活量监测的平均依从率为 59.47±24.60%。设备上生成的值与诊所获得的值具有良好的相关性。前一年的平均药物占有比（MPR）为 60%，研究期间为 65%（P=0.04）。CFQ-R 的平均治疗负担评分在入组时为 68，在研究完成时为 66（P=0.14）。
频繁的家庭 PFT 监测在 CF 青少年中是可行的，可以成功地提高药物依从性，而不会显著影响治疗负担。
