The Influence of Parental Supervision on Medical Adherence in Adolescents With Cystic Fibrosis: Developmental Shifts From Pre to Late Adolescence

Modi, Avani C.; Marciel, Kristen K.; Slater, Shalonda; Drotar, Dennis; Quittner, Alexandra L.

doi:10.1080/02739610701766925

Cited by 110 publications

(91 citation statements)

References 35 publications

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“…Therapies are often time consuming and challenging to deliver, so adherence may be poor, especially among certain groups, such as adolescents [28,29]. Dry powder mannitol offers the convenience of delivery to the lung via a simple, hand-held inhaler, rather than via a nebuliser, and it can be administered within 5 min [30].…”

Section: Discussionmentioning

confidence: 99%

Inhaled dry powder mannitol in cystic fibrosis: an efficacy and safety study

Bilton¹,

Robinson²,

Cooper³

et al. 2011

Eur Respir J

143

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This international phase III study of inhaled dry powder mannitol was a randomised, double-blind, 26-week study, followed by a further 26-week, open-label (OL) extension. 324 cystic fibrosis (CF) patients were randomised, in a 3:2 ratio, to mannitol (400 mg b.i.d.) and control groups. The primary efficacy end-point was to determine the change in forced expiratory volume in 1 s (FEV1) over the double-blind phase. Secondary end-points included changes in forced vital capacity and pulmonary exacerbations.A significant improvement in FEV1 was seen over 26 weeks (p,0.001) and was apparent by 6 weeks, irrespective of concomitant recombinant human deoxyribonuclease (rhDNase) use. At 26 weeks, there was a significant improvement in FEV1 of 92.9 mL for subjects receiving mannitol compared with controls (change from baseline 118.9 mL (6.5%) versus 26.0 mL (2.4%); p,0.001). Improvements in FEV1 were maintained up to 52 weeks in the OL part of the study. There was a 35.4% reduction in the incidence of having an exacerbation on mannitol (p50.045).The incidence of adverse events (AEs) was similar in both groups, although treatment-related AEs were higher in the mannitol compared with the control group. The most common mannitolrelated AEs were cough, haemoptysis and pharyngolaryngeal pain.Mannitol showed sustained, clinically meaningful benefit in airway function in CF, irrespective of concomitant rhDNase use. Mannitol appears to have an acceptable safety profile for patients with CF.

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Section: Discussionmentioning

confidence: 99%

Inhaled dry powder mannitol in cystic fibrosis: an efficacy and safety study

Bilton¹,

Robinson²,

Cooper³

et al. 2011

Eur Respir J

143

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“…This might be a crucial issue, as it has been shown that the right amount of parental supervision is important for health outcomes in adolescents with CF [40]. Additionally it has been shown, that tensions between adolescents and parents might have negative effects on the adolescent patients' lung function [13,41].…”

Section: Discussionmentioning

confidence: 99%

Anxiety and depression in adolescents with CF and their caregivers

Besier

Goldbeck

2011

Journal of Cystic Fibrosis

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“…Our study did not measure the processes by which parental depression may influence self-management, but it likely occurs through the dynamic interplay between self-management processes identified by the PSMF, including family functioning, parentchild communication, parental beliefs about treatment efficacy, family support, and parental supervision of treatments. 14,[17][18][19][20] There is evidence from 2 cross-sectional studies in pediatric patients with CF that the relationship between depression and treatment adherence may depend on 6…”

Section: Figurementioning

confidence: 99%

“…All of these processes have been linked to treatment adherence in CF. 14,[17][18][19][20] Given the elevated rates of depression documented in parents of children with CF and the theorized impact of parental depression on treatment adherence, the goal of the present article was to test whether parental depressive symptoms were predictive of adherence to enzyme regimens and whether that impact also affected short-term health outcomes. In accordance with the PSMF, we hypothesized that parental depressive symptoms would contribute to worse adherence, which in turn, would lead to worse weight outcomes.…”

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confidence: 99%