Treatment Regimen Adherence in Pediatric Gastroenterology

Hommel, Kevin A.; Mackner, Laura M.; Denson, Lee A.; Crandall, Wallace

doi:10.1097/mpg.0b013e318175dda1

Cited by 44 publications

(38 citation statements)

References 43 publications

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“…Adherence to an elimination diet J Tuokkola et al disease shows variation between 30 and 95%, depending on the methods used and the age of the children; no studies report adherence in an age group comparable with the present cohort of children under the age of 3 years (Hommel et al, 2008). Our results are based on 3-day food records, and we have no knowledge on the diets beyond those days, which is a limitation compared with the studies using questionnaires in defining the level of adherence.…”

Section: Discussionmentioning

confidence: 76%

Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet

et al. 2010

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Background/Objectives: The basic treatment for cow's milk allergy (CMA) is the elimination of all cow's milk proteins (CMP) from the diet. This study aimed at characterizing the diet of children with a diagnosis of CMA, to assess the degree of adherence to the elimination diet and to evaluate the factors associated with the adherence and age of recovery. Subjects/Methods: From a birth cohort study, food records of 267 children diagnosed with CMA were studied to define how strictly the elimination diet was adhered to. Subsequent food records were studied to assess the age at reintroduction of milk products in the child's diet. Results: The families adhered to the elimination diet of the child with extreme accuracy in 85% of the cases. Older and monosensitized children had more often small amounts of CMP in their diet, possibly because of the absence of nutritional information by a dietitian/nutritionist. Adherence to the diet was neither related to any other sociodemographic factor studied nor to the age at reintroduction of milk products into the diet. Conclusions: The therapeutic elimination diet of children diagnosed with CMA was well adhered to. Low intakes of vitamin D, calcium, and riboflavin are of concern in children who follow or have followed a cow's milk-free diet.

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Section: Discussionmentioning

confidence: 76%

Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet

et al. 2010

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“…questionnaires along with antibody testing, revealed discrepancies between 6% and 28.5% and the diet adherence was higher when using self-reporting compared to serological determination (Mariani 1998, Tommasini 2004, Hommel 2008, Jardesin 2008, Webb 2015. The fact that antibody analyses were not performed consistently in our study population could be considered a flaw.…”

Section: Gfd Compliancementioning

confidence: 63%

“…On the contrary, they are considered feasible, noninvasive ways of monitoring patients with chronic diseases (Hommel 2008). …”

Section: Gfd Compliancementioning

confidence: 99%

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Demographics, clinical features and treatment of pediatric celiac disease

Tapsas¹

2015

Linköping University Medical Dissertations

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Celiac disease (CD) is a chronic small intestinal immune-mediated enteropathy triggered by ingestion of gluten-containing food in genetically predisposed subjects. The enteropathy is presented with a wide variety of clinical manifestations, which can occur even outside the gastrointestinal tract. In the majority of cases, the diagnosis of CD is based on a small intestinal biopsy showing mucosal alterations, i.e. intraepithelial lymphocytosis, crypt hyperplasia, and villous atrophy. The treatment, gluten-free diet (GFD), has recently been revised with the addition of gluten-free oats. Oats give a more diversified nutrition and increase the fibre content. The use of oats in CD is though still debated in some reports. A strict life-long adherence to the GFD can be problematic, especially for pediatric CD patients. Sweden reported of one of the highest observed CD prevalences worldwide, i.e. 3%, among 12-year-olds born during what has been described as "the Swedish celiac epidemic", 1984−1996.The aims of this thesis were to elucidate how pediatric CD has changed during a 41-year period in Sweden, i.e. 1973Sweden, i.e. −2013, in terms of clinical presentation, disease severity, incidence, and demographics. We also wanted to adress the compliance to the GFD, the use of oats in the GFD and the safety of oats inclusion in the diet by measuring urinary nitric oxide (NO) metabolites.Filed information provided data about 2856 pediatric patients investigated for suspected CD between 1973 and 2013; of which 1030 patients were diagnosed with CD. After the data analyses the mean age of CD patients was shown to increase after the celiac epidemic period.Currently, CD shows a less severe picture in terms of symptoms and intestinal pathology.Younger children suffer primarily from gastrointestinal symptoms and growth failure, whereas extra-intestinal manifestations are more often displayed among adolescents. viWe also reported an unusually high pediatric CD incidence rate and cumulative incidence, likely the highest reported worldwide. We hypothesised that the introduction of new antibody tests would affect the diagnostic activity and accuracy in performing small intestinal biopsies for CD investigation. However, the outcome of diagnostic activity and accuracy could not clearly be attributed to the use of antibody tests due to changes occurring in parallel during the 41-year study period, e.g. a different pattern of symptoms at presentation and improved knowledge of the disease among parents and health professionals.In a questionnaire-based study our patient group reported a high compliance to the GFD.Long duration of the GFD may, however, influence compliance negatively. Oats have been included to the GFD of our study population in most of the cases without reporting major complications related to their well-being.The urinary measurements of NO metabolites revealed two patient groups, one with high and one with low levels. The two populations did not differ regarding sex, age, compliance to the GFD or oats consumption. Fa...

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“…Según algunos autores (11,(13)(14)(15)(16)(17)(18)(19), los métodos más utilizados para medir la adherencia son el auto-reporte, los datos de las reposiciones de farmacia, el test de Morisky-Green, el MEMS, la observación directa, el recuento de pastillas y los cuestionarios específicos de la enfermedad y cumplimiento de citas, todos estos con ventajas y desventajas a la hora de su uso.…”

Section: Introductionunclassified

Adherencia Al Tratamiento: Concepto Y Medición

Romero

Guevara

Parra

et al. 2016

hpsal

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ResumenObjetivo: realizar una síntesis del concepto de adherencia y describir los métodos empleados para medirla. Metodología: artículo de revisión. Se realizó una búsqueda, selección y revisión de artículos originales y secundarios escritos en inglés o español, en las diferentes bases de datos: Scielo, Pubmed, Cinahl, Science@direct y Ovidsp; publicados entre 2004 y 2013. Resultados: se seleccionaron 53 artículos, de los cuales 13 definían el concepto y la clasificación de los métodos, 32 fueron estudios de investigación que emplearon métodos indirectos, 17 combinaron métodos directos e indirectos y un estudio utilizó un método directo. Conclusiones: se evidenció el uso de diferentes conceptos a la hora de definir la adherencia, sin que exista un consenso. Asimismo, para la medición se utilizaron diferentes técnicas, la más común fue el uso de métodos indirectos, seguidos de la combinación de directos e indirectos. Palabras claveAdherencia al tratamiento, cumplimiento de la medicación, enfermedad crónica, evaluación en enfermería, métodos. (Fuente: DeCS, BIREME).

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Treatment Regimen Adherence in Pediatric Gastroenterology

Cited by 44 publications

References 43 publications

Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet

Cow's milk allergy in children: adherence to a therapeutic elimination diet and reintroduction of milk into the diet

Demographics, clinical features and treatment of pediatric celiac disease

Adherencia Al Tratamiento: Concepto Y Medición

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