Maddux Michele H, Ricks Shawna, Bass Julie A, Daniel James F, Carpenter Ellen, Radford Kimberely
Division of Developmental and Behavioral Sciences, Children's Mercy-Kansas City, Kansas City, MO, USA,
Division of Gastroenterology, Children's Mercy-Kansas City, Kansas City, MO, USA,
Ther Clin Risk Manag. 2018 Jul 11;14:1227-1234. doi: 10.2147/TCRM.S159611. eCollection 2018.
Despite significant medication nonadherence rates among youth with pediatric gastroenterology and hepatology disorders, little is known about current adherence practices in pediatric gastroenterology care. This study summarizes current practices surrounding adherence monitoring and intervention in pediatric gastrointestinal (GI) and hepatologic care in the USA.
One hundred and fifty-four pediatric GI providers completed an online survey designed to examine current practices surrounding adherence monitoring and intervention, specific strategies used to monitor and treat poor adherence, and the barriers currently experienced in relation to adherence monitoring and intervention.
Practices varied greatly in terms of when and how patient adherence is monitored and by whom; however, physicians and nursing professionals take primary responsibility for adherence monitoring. Approximately 25% utilize screeners to assess adherence, and most participants use patient and caregiver reports as a primary measure of adherence. Most participants rated their level of adherence monitoring and intervention as fair to poor. While most participants perceive adherence monitoring to be very important in clinical practice, only 20.8% perceive being able to significantly modify patient adherence.
There exists great variability in adherence monitoring and intervention practices across pediatric GI providers. Greater understanding of current adherence practices can inform future clinical efforts.
尽管患有儿科胃肠病和肝病的青少年药物治疗不依从率很高，但目前对于儿科胃肠病护理中的依从性实践知之甚少。本研究总结了美国儿科胃肠（GI）和肝病护理中围绕依从性监测和干预的当前实践。
154名儿科胃肠病提供者完成了一项在线调查，该调查旨在检查围绕依从性监测和干预的当前实践、用于监测和治疗依从性差的具体策略，以及目前在依从性监测和干预方面遇到的障碍。
在何时、如何以及由谁监测患者依从性方面，实践差异很大；然而，医生和护理专业人员对依从性监测承担主要责任。约25%的人使用筛查工具来评估依从性，大多数参与者将患者和照顾者的报告作为依从性的主要衡量标准。大多数参与者将他们的依从性监测和干预水平评为一般到较差。虽然大多数参与者认为依从性监测在临床实践中非常重要，但只有20.8%的人认为能够显著改变患者的依从性。
儿科胃肠病提供者在依从性监测和干预实践方面存在很大差异。对当前依从性实践的更深入了解可为未来的临床工作提供参考。
