美国青少年和成人嗜酸性食管炎患者对非标签使用皮质类固醇的满意度及依从性:一项基于网络调查的结果

Satisfaction With and Adherence to Off-Label Corticosteroids in Adolescents and Adults With Eosinophilic Esophagitis: Results of a Web-Based Survey in the United States.

作者信息

Gold Benjamin D, Goodwin Bridgett, Davis Kimberly, Sweeney Carolyn, Ziemiecki Ryan, Jiang Jeanne, Fan Tao, Boules Mena, Chen Szu-Ta, Katzka David A

机构信息

GI Care for Kids, Children's Center for Digestive Healthcare LLC, Atlanta, GA.

Takeda Development Center Americas Inc., Cambridge, MA.

出版信息

J Clin Gastroenterol. 2025 Feb 1;59(2):138-146. doi: 10.1097/MCG.0000000000002006.

Abstract

GOALS

We assessed satisfaction with and adherence to off-label corticosteroids in patients with eosinophilic esophagitis (EoE) in the United States.

BACKGROUND

EoE is a chronic inflammatory disease for which there are currently no US Food and Drug Administration-approved swallowed topical corticosteroids.

STUDY

This noninterventional, cross-sectional, web-based survey included caregivers of adolescents (aged 11 to 17 y) and adults (aged 18 years or older) with a self-reported [or caregiver-reported (adolescents)] physician diagnosis of EoE who were receiving corticosteroids. Participants were recruited through 2 nonprofit, patient advocacy groups. The 9-item Treatment Satisfaction Questionnaire for Medication (TSQM-9) was used to assess satisfaction across effectiveness, convenience, and global satisfaction domains (scale: 1 to 100 per domain); higher scores indicated greater satisfaction. The 4-item Morisky Green Levine Medication Adherence Scale (MGL-4) was used to assess adherence; an MGL-4 score of <3 indicated adherence. Participants also reported reasons for nonadherence.

RESULTS

Overall, 201 participants (caregivers of adolescents, n=98; adults, n=103) were included in this study. Mean TSQM-9 scores indicated low satisfaction with off-label corticosteroids across all 3 satisfaction domains in adolescents (≤61.1) and adults (≤55.7). Slightly fewer adolescents (37.1%) than adults (40.8%) were considered adherent. Forgetfulness was the most frequently reported reason for nonadherence; some patients chose not to take their medications, owing to poor palatability (adolescents), difficulty taking medications at specific times (adults), or feeling depressed/overwhelmed (adolescents and adults).

CONCLUSIONS

Satisfaction with and adherence to off-label corticosteroids were low in this web-based survey of adolescents and adults with EoE in the United States.

摘要

目标

我们评估了美国嗜酸性粒细胞性食管炎(EoE)患者对标签外使用的皮质类固醇的满意度和依从性。

背景

EoE是一种慢性炎症性疾病,目前美国食品药品监督管理局尚未批准任何可吞咽的局部皮质类固醇药物。

研究

这项基于网络的非干预性横断面调查纳入了青少年(11至17岁)和成人(18岁及以上)中自我报告[或青少年由照顾者报告]经医生诊断为EoE且正在接受皮质类固醇治疗的患者。参与者通过2个非营利性患者权益倡导组织招募。使用9项药物治疗满意度问卷(TSQM-9)评估有效性、便利性和总体满意度领域的满意度(每个领域评分范围为1至100);分数越高表明满意度越高。使用4项Morisky Green Levine药物依从性量表(MGL-4)评估依从性;MGL-4得分<3表明依从。参与者还报告了不依从的原因。

结果

总体而言,本研究纳入了201名参与者(青少年照顾者,n = 98;成人,n = 103)。TSQM-9平均得分表明青少年(≤61.1)和成人(≤55.7)在所有3个满意度领域对标签外皮质类固醇的满意度较低。被认为依从的青少年(37.1%)略少于成人(40.8%)。遗忘是最常报告的不依从原因;一些患者因药物口感差(青少年)、在特定时间服药困难(成人)或感到沮丧/不堪重负(青少年和成人)而选择不服药。

结论

在美国这项针对青少年和成人EoE患者的基于网络的调查中,对标签外皮质类固醇的满意度和依从性较低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/294e/11702899/8c97a74f27fc/mcg-59-138-g001.jpg

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