Yang Chunsong, Song Xia, Wu Jin, Zhang Lingli
Department of Pharmacy, West China Second University Hospital, Sichuan University, Chengdu, China.
Evidence-Based Pharmacy Center, West China Second University Hospital, Sichuan University, Chengdu, China.
Front Pharmacol. 2024 Jan 8;14:1269158. doi: 10.3389/fphar.2023.1269158. eCollection 2023.
This study aimed to investigate the prevalence and influencing factors of medication adherence in children with central precocious puberty (CPP), and provide references for clinical practice. Children under 12 years of age with CPP and their caregivers at a women's and children's hospital were selected for a cross-sectional study from February to May 2023, and a questionnaire was used to collect basic characteristics of pediatric patients and their caregivers, information of medication, cognition of medication, and medication adherence. The 8-item Morisky Medication Adherence Scale (MMAS-8) was adopted to assess medication adherence, and the potential influencing factors were explored by univariate and multivariate analyses. A total of 125 valid questionnaires were collected. The medication adherence rate of children with CPP reported by caregivers was 76.0%. The univariate analysis showed that the percentage of parental caregivers ( = 0.027), the age of caregivers ( = 0.029), the education level of caregivers ( = 0.001), the financial burden ( < 0.000), the incidence of adverse effects ( = 0.008), and the cognition of medication including the importance of medication ( = 0.002), the dosage of medication ( = 0.002), the adverse effects of medication ( = 0.007), the harm of non-compliance with medication ( < 0.000), and the evaluation of the price of medication ( = 0.003) in the poor adherence group were significantly inferior to those in the better adherence group. The multivariate analysis showed that the higher incidence of adverse effects ( = 0.20), not understanding the harm of non-compliance with medication ( = 0.004), and evaluation of the price of medication as expensive ( = 0.043) were independent risk factors for poor medication adherence. Medication adherence in children with CPP is relatively better, and the factors leading to poor medication adherence are mainly on the caregivers of pediatric patients. It is recommended to increase the health education among caregivers of children with CPP to enhance the cognition of the condition and medication, and further improve the therapeutic efficacy for CPP.
本研究旨在调查中枢性性早熟（CPP）儿童的用药依从性及其影响因素，为临床实践提供参考。选取2023年2月至5月在某妇幼医院就诊的12岁以下CPP患儿及其照顾者进行横断面研究，采用问卷调查收集患儿及其照顾者的基本特征、用药信息、用药认知及用药依从性。采用8条目Morisky用药依从性量表（MMAS-8）评估用药依从性，通过单因素和多因素分析探讨潜在影响因素。共收集有效问卷125份。照顾者报告的CPP患儿用药依从率为76.0%。单因素分析显示，依从性差组的家长照顾者比例（P = 0.027）、照顾者年龄（P = 0.029）、照顾者文化程度（P = 0.001）、经济负担（P < 0.000）、不良反应发生率（P = 0.008）以及用药认知包括用药重要性（P = 0.002）、用药剂量（P = 0.002）、药物不良反应（P = 0.007）、不遵医嘱的危害（P < 0.000）和对药物价格的评价（P = 0.003）均显著低于依从性较好组。多因素分析显示，不良反应发生率较高（P = 0.20）、不了解不遵医嘱的危害（P = 0.004）以及认为药物价格昂贵（P = 0.043）是用药依从性差的独立危险因素。CPP患儿的用药依从性相对较好，导致用药依从性差的因素主要在患儿的照顾者。建议加强对CPP患儿照顾者的健康教育，提高其对病情和用药的认知，进一步提高CPP的治疗效果。
