Suchismita Arya, Ashritha A, Sood Vikrant, Lal Bikrant B, Khanna Rajeev, Kumar Guresh, Alam Seema
Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India.
Department of Clinical Research, Institute of Liver & Biliary Sciences, New Delhi, India.
J Clin Exp Hepatol. 2023 Jan-Feb;13(1):22-30. doi: 10.1016/j.jceh.2022.10.006. Epub 2022 Oct 17.
BACKGROUND/OBJECTIVES: Adherence to medication(s) is an essential component of holistic management in any chronic disease including in post liver transplant (LT) patients. Thus, this study aimed to assess adherence to medications in Indian pediatric liver disease patients (including post LT recipients) and to identify variables affecting its occurrence.
A cross-sectional study was conducted among pediatric (<18 years of age) subjects with Wilson disease (WD) and autoimmune liver disease (AILD) along with post LT recipients from May 2021 to October 2021. Structured tools using prevalidated questionnaires ( and the & ) were used to collect data related to nonadherence prevalence (based on missed and late doses) and factors influencing the adherence.
A total of 152 children were included in the study (WD 39.5%, AILD 32.9%, and post LT 27.6%). Prevalence of missed and late dose nonadherence (at a cut-off of ≥20%) was 12.5% and 16.4%, respectively. Older age (odd's ratio/O.R 1.185), stay in a rural area (O.R 5.08), and barriers like (O.R 4.728) and (O.R 7.180) were independently associated with nonadherence ( < 0.05).
Overall, nonadherence was seen in 12-16%, i.e., around one-sixth of the patients, with least nonadherence seen in post LT recipients (0-2.4%). Older age of the patient, rural place of stay and personal barriers like hard to remember/forgetfulness and bad medication taste were identified as factors independently leading to nonadherence.
背景/目的:坚持服药是包括肝移植后患者在内的任何慢性病整体管理的重要组成部分。因此,本研究旨在评估印度儿科肝病患者(包括肝移植后受者)的服药依从性,并确定影响其发生的变量。
于2021年5月至2021年10月,对患有威尔逊病(WD)和自身免疫性肝病(AILD)的儿科(<18岁)受试者以及肝移植后受者进行了一项横断面研究。使用经过预验证的问卷(以及&)的结构化工具来收集与不依从患病率(基于漏服和迟服剂量)以及影响依从性的因素相关的数据。
共有152名儿童纳入研究(WD占39.5%,AILD占32.9%,肝移植后占27.6%)。漏服和迟服剂量不依从的患病率(临界值≥20%)分别为12.5%和16.4%。年龄较大(比值比/OR 1.185)、居住在农村地区(OR 5.08)以及诸如(OR 4.728)和(OR 7.180)等障碍与不依从独立相关(<0.05)。
总体而言,12 - 16%的患者存在不依从情况,即约六分之一的患者,肝移植后受者的不依从情况最少(0 - 2.4%)。患者年龄较大、居住在农村以及诸如难以记住/健忘和药物味道不佳等个人障碍被确定为导致不依从的独立因素。