Department of Gastroenterology & Hepatology, Amsterdam UMC, Amsterdam, the Netherlands.
Am J Gastroenterol. 2022 Sep 1;117(9):1412-1418. doi: 10.14309/ajg.0000000000001850. Epub 2022 Jun 3.
To investigate the adherence to prescribed medical and dietary maintenance treatments in a cohort of adult patients with eosinophilic esophagitis (EoE) and to identify associated factors.
In this cross-sectional study, adult patients with EoE who were prescribed medical or dietary maintenance therapy were included. Patients were asked to complete questionnaires concerning treatment adherence (Medication Adherence Rating Scale), beliefs about treatment (Beliefs about Medicine Questionnaire), beliefs about disease (Illness Perception Questionnaire), and current symptoms (Straumann Dysphagia Index).
A total of 177 patients with EoE (71% males) were included, with a median age of 43 years. The overall prevalence of poor adherence to prescribed treatments (Medication Adherence Rating Scale < 21 or Diet Adherence Rating Scale < 21) in this cohort was high, being 41.8%. Medically treated patients seemed less adherent to prescribed treatment compared with patients prescribed a diet (35.1% vs 41.8%, P = 0.320). Multivariate logistic regression analyses identified the following independent factors associated with poor treatment adherence: age <40 years (odds ratio [OR] 2.571, 95% CI 1.195-5.532, P = 0.016), longer disease duration in years (OR 1.130, 95% CI 1.014-1.258, P = 0.027), severe symptoms (Straumann Dysphagia Index) (OR 1.167, 95% CI 1.012-1.345, P = 0.034), and low necessity beliefs (OR 4.423, 95% CI 2.169-9.016, P < 0.001).
Adherence to maintenance treatment is poor in many adult patients with EoE. Clinicians should pay more attention to treatment adherence, particularly in younger patients, and discuss the necessity of treatment.
本研究旨在调查嗜酸性粒细胞性食管炎（EoE）成年患者对医嘱治疗的坚持情况，并识别相关影响因素。
本横断面研究纳入了接受药物或饮食维持治疗的 EoE 成年患者。患者需完成关于治疗依从性（用药依从性评定量表）、治疗信念（药物信念问卷）、疾病信念（疾病感知问卷）和当前症状（Straumann 吞咽困难指数）的问卷。
共纳入 177 例 EoE 患者（71%为男性），中位年龄为 43 岁。该队列中，医嘱治疗（用药依从性评定量表＜21 分或饮食依从性评定量表＜21 分）总体依从性差的比例较高，为 41.8%。与接受饮食治疗的患者相比，接受药物治疗的患者似乎对医嘱治疗的依从性更差（35.1%比 41.8%，P=0.320）。多变量逻辑回归分析确定了以下与治疗依从性差相关的独立因素：年龄＜40 岁（比值比[OR]2.571，95%置信区间[CI]1.195-5.532，P=0.016）、疾病持续时间更长（OR 1.130，95%CI 1.014-1.258，P=0.027）、严重症状（Straumann 吞咽困难指数）（OR 1.167，95%CI 1.012-1.345，P=0.034）和低必要性信念（OR 4.423，95%CI 2.169-9.016，P＜0.001）。
许多 EoE 成年患者对维持治疗的依从性差。临床医生应更加关注治疗依从性，尤其是在年轻患者中，并讨论治疗的必要性。
