Department of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
School of Computer Science and Statistics, Trinity College Dublin, Ireland.
Trans R Soc Trop Med Hyg. 2021 Aug 2;115(8):904-913. doi: 10.1093/trstmh/traa161.
Information on the extent of patient medication adherence and the use of interventions to advance adherence are scarce in clinical practice. This study aimed to assess medication adherence and risk factors for non-adherence among the caregivers of children with tuberculosis (TB).
This prospective study was conducted among the caregivers of 443 child TB patients registered during the study. Caregivers of children were queried using a structured questionnaire consisting of sociodemographic and socio-economic factors and the role of healthcare workers during the treatment course. Risk factors for non-adherence were estimated using a logistic regression model.
In multivariate analysis, the independent variables that had a statistically significant positive association with non-adherence were male sex (adjusted odds ratio [AOR] 5.870 [95% confidence interval {CI} 1.99 to 17.29]), age ≥45 y (AOR 5.627 [95% CI 1.88 to 16.82]), caregivers with no formal education (AOR 3.905 [95% CI 1.29 to 11.79]), financial barriers (AOR 30.297 [95% CI 6.13 to 149.54]), insufficient counselling by healthcare workers (AOR 5.319 [95% CI 1.62 to 17.42]), insufficient counselling by health professionals (AOR 4.117 [95% CI 1.05 to 16.05]) and unfriendly attitude and poor support from healthcare professionals (AOR 11.150 [95% CI 1.91 to 65.10]).
Treatment adherence in the present study was 86% using the Morisky Green Levine Medication Adherence Scale and 90.7% using the visual analogue scale tool. Predictors of non-adherence need to be a focus and caregivers should be given complete knowledge about the importance of adherence to TB treatment.
在临床实践中，关于患者用药依从性的程度以及使用干预措施来提高依从性的信息非常有限。本研究旨在评估结核病（TB）患儿照顾者的用药依从性及其不依从的危险因素。
本前瞻性研究在研究期间登记的 443 名儿童结核病患者的照顾者中进行。使用由社会人口统计学和社会经济学因素以及治疗过程中医务人员角色组成的结构化问卷对照顾者进行了询问。使用逻辑回归模型估计不依从的危险因素。
在多变量分析中，与不依从性有统计学显著正关联的独立变量为男性（校正比值比[OR] 5.870[95%置信区间{CI} 1.99 至 17.29]）、年龄≥45 岁（OR 5.627[95% CI 1.88 至 16.82]）、无正规教育的照顾者（OR 3.905[95% CI 1.29 至 11.79]）、经济障碍（OR 30.297[95% CI 6.13 至 149.54]）、医护人员提供的咨询不足（OR 5.319[95% CI 1.62 至 17.42]）、卫生专业人员提供的咨询不足（OR 4.117[95% CI 1.05 至 16.05]）以及医护人员的不友好态度和支持不足（OR 11.150[95% CI 1.91 至 65.10]）。
本研究中使用 Morisky Green Levine 药物依从性量表的依从性为 86%，使用视觉模拟量表工具的依从性为 90.7%。不依从的预测因素需要成为关注的焦点，应向照顾者提供有关结核病治疗依从性重要性的全面知识。
