A multi-method assessment of treatment adherence for children with cystic fibrosis

Modi, Avani C.; Lim, Crystal S.; Yu, Nami S.; Geller, David H.; Wagner, Mary H.; Quittner, Alexandra L.

doi:10.1016/j.jcf.2006.03.002

Cited by 226 publications

(242 citation statements)

References 26 publications

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“…There are also limitations to all adherence measures, including pharmacy refill records. Limitations of pharmacy refill records include that their accuracy may be affected by dosage changes and that they do not indicate whether medication is actually consumed according to the prescribed dosing schedule (43)(44)(45). However, as previously stated, prior research has found that RTRs who appropriately refill their IST are more likely to have desired IST serum concentrations, and therefore we believe pharmacy refill records are a reliable and valid measure of IST adherence (12).…”

Section: Discussionmentioning

confidence: 83%

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Chisholm-Burns

Spivey

Zivin

et al. 2013

American Journal of Transplantation

103

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The objective of this randomized controlled trial was to assess the effects of a 1-year behavioral contract intervention on immunosuppressant therapy (IST) adherence and healthcare utilizations and costs among adult renal transplant recipients (RTRs). The sample included adult RTRs who were at least 1 year posttransplant, taking tacrolimus or cyclosporine and served by a specialty pharmacy. Pharmacy refill records were used to measure adherence and monthly questionnaires were used to measure healthcare utilizations. Direct medical costs were estimated using the 2009 Medicare Expenditure Panel Survey. Adherence was analyzed using the GLM procedure and the MIXED procedure of SAS. Rate ratios and 95% confidence intervals were estimated to quantify the rate of utilizing healthcare services relative to treatment assignment. One hundred fifty RTRs were enrolled in the study. Intervention group RTRs (n ¼ 76) had higher adherence than control group RTRs (n ¼ 74) over the study period (p < 0.01). And 76.1% of the intervention group compared with 42.7% of the control group was not hospitalized during the 1-year study period (RR ¼ 1.785; 95% CI: 1.314, 2.425), resulting in cost savings. Thus, evidence supports using behavioral contracts as an effective adherence intervention that may improve healthcare outcomes and lower costs.

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Section: Discussionmentioning

confidence: 83%

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Chisholm-Burns

Spivey

Zivin

et al. 2013

American Journal of Transplantation

103

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“…In a recent US study, adult patients -of whom only half had performed airway clearance -reported a mean time spent on treatment activities of 108 minutes per day (Sawicki et al, 2009). Though very difficult to assess (Modi et al, 2006), treatment adherence is undoubtedly a key issue in CF (Eakin et al, 2011) and requires permanent assessment and support (Pendleton, 2000). There is no magic recipe, but this subject has to be bridged at every consultation, in an open manner, with empathy and as part of a 'therapeutic alliance' (Lask, 1994;Cohen-Cymberknoh et al, 2011).…”

Section: Many Other Challenges…mentioning

confidence: 99%

The Prognosis of Cystic Fibrosis - A Clinician's Perspective

Lebecque¹

2012

Cystic Fibrosis - Renewed Hopes Through Research

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“…22 Adherence is a particular issue in young people as they are beginning to take over management of their illness. In addition, certain developmental issues (e.g.…”

Section: Adherencementioning

confidence: 99%

“…In order to improve adherence the initial task is to quantify the level of adherence for each treatment. 22 Determine the barriers to adherence These can be anything from simply not liking the taste of a particular medicine, to family reasons, to not prioritizing illness management to rebellion. Only then can the reasons be worked on.…”

Section: Determine the Level Of Adherencementioning

confidence: 99%

Adolescence: What the cystic fibrosis team needs to know

Segal

2008

J R Soc Med

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Adolescence can be defined as a period of biopsychosocial transition from a dependent child to an autonomous/independent adult, usually taking place between 13 and 20 years of age. There is considerable variation between individuals and cultures-in some it is truncated to circumcision. As a group adolescents make up 13% of the general population, but they probably account for about 30-40% of both the paediatrician and adult physician's workload, especially when dealing with a chronic disease of limited life span. Adolescence constitutes a large proportion of the life of a patient with cystic fibrosis (CF). The treatment of adolescents poses specific challenges for treating disease and promoting health. In working with adolescents, the treatments for disease are played out against a background of rapid physical, psychological and social developmental changes; changes that produce unique communication and management challenges. At no other time of life are the physical and psychosocial elements of illness and behaviour so inextricably intertwined as in adolescence. This can make working with adolescents difficult; however, given the right skills-which can be learned!-practising medicine with young people can be extremely rewarding and productive.

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A multi-method assessment of treatment adherence for children with cystic fibrosis

Cited by 226 publications

References 26 publications

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

Improving Outcomes of Renal Transplant Recipients With Behavioral Adherence Contracts: A Randomized Controlled Trial

The Prognosis of Cystic Fibrosis - A Clinician's Perspective

Adolescence: What the cystic fibrosis team needs to know

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