Determinants of adherence in adults with cystic fibrosis

Kettler, Lisa; Sawyer, Susan Μ; Winefield, HR; Greville, Hugh

doi:10.1136/thorax.57.5.459

Cited by 127 publications

(143 citation statements)

References 36 publications

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“…Future studies should analyze the duration of AAV-mediated gene expression, shown for some transgenes to persist for 1.5 years in animal models, 54-57 a feature that is clinically relevant for a population of patients with CF who receive multiple therapies a day. 58 …”

Section: Il-mentioning

confidence: 99%

IL-10 delivery by AAV5 vector attenuates inflammation in mice with pseudomonas pneumonia

Buff

McCall

et al. 2010

Gene Ther

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Section: Il-mentioning

confidence: 99%

IL-10 delivery by AAV5 vector attenuates inflammation in mice with pseudomonas pneumonia

Buff

McCall

et al. 2010

Gene Ther

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“…'compliance' , 'adherence' , 'persistence' , and 'concordance' , are used to define different aspects of the act of seeking medical attention, acquiring prescriptions and taking medicines appropriately [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37]. These terms are often used interchangeably, but they impose different views about the relationship between the patient and the health care professional [38][39][40].…”

Section: Introductionmentioning

confidence: 99%

A New Taxonomy for Describing and Defining Adherence to Medications

Vrijens

Geest

Hughes

et al. 2011

British Journal of Clinical Pharmacology

232

316

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Interest in patient adherence has increased in recent years, with a growing literature that shows the pervasiveness of poor adherence to appropriately prescribed medications. However, four decades of adherence research has not resulted in uniformity in the terminology used to describe deviations from prescribed therapies. The aim of this review was to propose a new taxonomy, in which adherence to medications is conceptualized, based on behavioural and pharmacological science, and which will support quantifiable parameters. A systematic literature review was performed using MEDLINE, EMBASE, CINAHL, the Cochrane Library and PsycINFO from database inception to 1 April 2009. The objective was to identify the different conceptual approaches to adherence research. Definitions were analyzed according to time and methodological perspectives. A taxonomic approach was subsequently derived, evaluated and discussed with international experts. More than 10 different terms describing medication-taking behaviour were identified through the literature review, often with differing meanings. The conceptual foundation for a new, transparent taxonomy relies on three elements, which make a clear distinction between processes that describe actions through established routines ('Adherence to medications' , 'Management of adherence') and the discipline that studies those processes ('Adherence-related sciences'). 'Adherence to medications' is the process by which patients take their medication as prescribed, further divided into three quantifiable phases: 'Initiation' , 'Implementation' and 'Discontinuation' . In response to the proliferation of ambiguous or unquantifiable terms in the literature on medication adherence, this research has resulted in a new conceptual foundation for a transparent taxonomy. The terms and definitions are focused on promoting consistency and quantification in terminology and methods to aid in the conduct, analysis and interpretation of scientific studies of medication adherence.

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“…Still, the poor adherence rate cited here is comparable to that of prospective, longitudinal research comparing various ACT techniques, 20 and with self-reporting, a wide range of behaviors often surfaces as patients identify and describe specific barriers to adherence. 21,22 …”

Section: Discussionmentioning

confidence: 99%

Adherence to Airway Clearance Therapies by Adult Cystic Fibrosis Patients

Flores¹,

Teixeira²,

Rovedder

et al. 2013

Respir Care

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BACKGROUND: Airway clearance therapy (ACT) is critical in cystic fibrosis (CF). OBJEC-TIVES:To determine rates of self-reported adherence to ACT by patients treated in an adult CF program, to identify patient characteristics associated with poor adherence, to typify adherence according to ACT technique, and to indicate reasons for poor adherence. METHODS: Our crosssectional study included CF subjects age 16 years and older. Enrollees were evaluated via general structured questionnaire, adherence questionnaire, clinical assessment, spirometry, and S pO 2 values. Each was stratified by self-reporting protocol as high, moderate, or poor adherence to ACT. Concordance between physiotherapist recommended ACT technique and self-reported subject adherence was subjected to agreement analysis. RESULTS: Of the 63 subjects studied, 38 (60%) qualified as high adherence, 12 (19%) as moderate adherence, and 13 (21%) as poor adherence. Logistic regression identified education level (less than high school) as an independent factor associated with poor adherence (odds ratio 10.2, 95% CI 1.23-84.7, P ‫؍‬ .03). Positive expiratory pressure ( ‫؍‬ 0.87) and flutter device ( ‫؍‬ 0.63) usage both corresponded with a high level of agreement, while active cycle of breathing technique ( ‫؍‬ 0.40) and autogenic drainage ( ‫؍‬ 0.39) each showed moderate agreement. Agreement was low for percussion and postural drainage ( ‫؍‬ 0.23). Reasons given most frequently for poor adherence to ACT were "not enough time to do ACT" (28%), "cannot be bothered" (16%), and "do not enjoy ACT technique" (8%). Many (32%) provided no reason. CONCLUSIONS: Study outcomes showed a high rate of ACT adherence in adult CF subjects. Lower level of education was the most important factor in poor adherence to ACT. Self-reported adherence and treatment recommendations were in best agreement with positive expiratory pressure and flutter device techniques.

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Determinants of adherence in adults with cystic fibrosis

Cited by 127 publications

References 36 publications

IL-10 delivery by AAV5 vector attenuates inflammation in mice with pseudomonas pneumonia

IL-10 delivery by AAV5 vector attenuates inflammation in mice with pseudomonas pneumonia

A New Taxonomy for Describing and Defining Adherence to Medications

Adherence to Airway Clearance Therapies by Adult Cystic Fibrosis Patients

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