Capozza Korey, Schwartz Alan
Global Parents for Eczema Research, Los Angeles, California.
Department of Medical Education and Department of Pediatrics, University of Illinois Chicago, Chicago, Illinois.
Pediatr Dermatol. 2020 Jan;37(1):58-61. doi: 10.1111/pde.13991. Epub 2019 Aug 28.
Though adherence is low among caregivers of children with atopic dermatitis (AD), the reasons for it are poorly understood. This study aims to assess the self-reported prevalence of non-adherence and reasons for changing prescription regimens among parents of children with AD.
A link to a 15-question online survey was posted to social media sites engaging parents of children with eczema, worldwide. Items included a scale related to physician trust. Results were analyzed using R 3.4 and summarized using normal and nonparametric descriptive statistics as appropriate for each item.
Eighty-six eligible parents responded to the survey and provided information about medication adherence. The mean age of respondents' children was 6.2 years (SD 4.4 years), and the majority were children with moderate or severe eczema (40.5% moderate and 42.9% severe). Just over half (54.7%) reported taking or applying eczema medications as directed by their physician. Of those that did not, 30.2% took or applied less medications, and 12.8% stopped taking or applying medications altogether. The top reasons for deviating from directions were as follows: (a) worry about side effects, (b) symptom resolution, and (c) perception that the medication was not working. Trust toward physician was significantly associated with taking medication as directed.
Decisions about adherence to medications are made in the context of perceived benefits versus anticipated side effects. Findings highlight opportunities for improving adherence, and thereby improving outcomes for children with moderate-severe AD.
尽管特应性皮炎（AD）患儿的 caregivers 依从性较低，但其原因尚不清楚。本研究旨在评估 AD 患儿家长自我报告的不依从患病率以及改变处方治疗方案的原因。
在全球范围内，向参与湿疹患儿家长的社交媒体网站发布了一份包含 15 个问题的在线调查问卷链接。项目包括与医生信任相关的量表。使用 R 3.4 对结果进行分析，并根据每个项目的情况使用正态和非参数描述性统计进行总结。
86 名符合条件的家长回复了调查问卷，并提供了关于药物依从性的信息。受访者孩子的平均年龄为 6.2 岁（标准差 4.4 岁），大多数是中度或重度湿疹患儿（40.5%为中度，42.9%为重度）。略超过一半（54.7%）的家长报告按照医生的指示服用或涂抹湿疹药物。在未按指示服药的家长中，30.2%服用或涂抹的药物较少，12.8%完全停止服用或涂抹药物。偏离指示的主要原因如下：（a）担心副作用，（b）症状缓解，以及（c）认为药物无效。对医生的信任与按指示服药显著相关。
关于药物依从性的决定是在感知到的益处与预期的副作用的背景下做出的。研究结果突出了改善依从性的机会，从而改善中度至重度 AD 患儿的治疗效果。
