Department of Pediatrics, Yüksek İhtisas Education and Research Hospital, Bursa, Turkey.
Department of Child and Adolescent Psychiatry, Yüksek İhtisas Education and Research Hospital, Bursa, Turkey.
P R Health Sci J. 2020 Mar;39(1):45-50.
To investigate the relationship between caregivers' health literacy and adherence to treatment in children with epilepsy.
The participants included 226 children and adolescents with epilepsy and their primary caregivers. The demographic and clinical characteristics were abstracted. An antiepileptic drug adherence assessment was done with the validated Morisky Medication Adherence Scale-8 (MMAS-8). According to the scale's scoring system, 0 points indicates high adherence, 1 to 2 points, moderate adherence, and 3 to 8 points, low adherence. A 17-item public health literacy knowledge scale (PHLKS) was used to measure the caregivers' levels of health knowledge. For this scale, higher scores indicate higher levels of health knowledge. A logistic regression model was used to evaluate the effects of demographic characteristics and clinical findings on full drug adherence.
The overall prevalence of complete drug adherence among patients was 47.3%. The median value of the MMAS-8 score was 1 point (0-8 points). The main reasons for high scores were forgetting to take medication (33.6%) and the difficulties in adhering to treatment (24.3%). The median of the PHLKS score was 13 points (4-17 points). According to the logistic regression results, patients in the 0 to 5 years age group were more likely to have full drug adherence than were those in the 12 to 18 years age group (OR [95% CI]: 2.9 [1.4-6.5]; p = 0.007). As the PHLKS score increased, drug adherence also significantly increased (OR [95% CI]: 0.8 [0.7-0.9]; p = 0.008).
Age and caregivers' health literacy knowledge were found to be significantly associated with adherence. To better define the factors associated with drug adherence in children with epilepsy, additional research (using objective, validated tools) aimed at determining caregivers' health literacy is needed.
调查照顾者健康素养与癫痫患儿治疗依从性之间的关系。
参与者包括 226 名癫痫儿童及其主要照顾者。提取人口统计学和临床特征。采用经过验证的 Morisky 药物依从性量表-8（MMAS-8）对癫痫药物依从性进行评估。根据量表的评分系统，0 分表示高度依从，1-2 分表示中度依从，3-8 分表示低度依从。使用 17 项公共卫生素养知识量表（PHLKS）来衡量照顾者的健康知识水平。对于这个量表，得分越高表示健康知识水平越高。采用逻辑回归模型评估人口统计学特征和临床发现对完全药物依从的影响。
患者完全药物依从的总体患病率为 47.3%。MMAS-8 评分中位数为 1 分（0-8 分）。高分的主要原因是忘记服药（33.6%）和难以坚持治疗（24.3%）。PHLKS 评分中位数为 13 分（4-17 分）。根据逻辑回归结果，0-5 岁年龄组的患者比 12-18 岁年龄组的患者更有可能完全药物依从（OR[95%CI]：2.9[1.4-6.5]；p=0.007）。随着 PHLKS 评分的增加，药物依从性也显著增加（OR[95%CI]：0.8[0.7-0.9]；p=0.008）。
年龄和照顾者的健康素养知识与依从性显著相关。为了更好地确定与癫痫儿童药物依从性相关的因素，需要进行额外的研究（使用客观、经过验证的工具）来确定照顾者的健康素养。
