Opportunities for cystic fibrosis care teams to support treatment adherence

Riekert, Kristin A.; Eakin, Michelle N.; Bilderback, Andrew; Ridge, Alana K.; Marshall, Bruce C.

doi:10.1016/j.jcf.2014.10.003

Cited by 38 publications

(40 citation statements)

References 26 publications

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“…Education, while necessary, is certainly not sufficient 42–44. Communication is crucial and allowing patients to understand the importance of their regimens will be important, but understanding how the treatments fit into their lives and their values is also paramount to working on decreasing these barriers 39. With this in mind, we have identified three primary future directions for research and service development to optimize adherence in adolescents with CF (Table 1).…”

Section: Discussion and Future Directionsmentioning

confidence: 99%

“…Research to date indicates that lower adherence to prescribed medication regimens may be in part due to difficulties with time management, forgetting, increased complexity of regimens, decreased parental supervision, perceived doubts about the necessity of treatments, stigma and reluctance to disclose CF status, and depression in both patients and their parents 1,5,9,11,24,29–39…”

Section: Known Barriers To Treatment Adherence In Adolescents With Cfmentioning

confidence: 99%

“…Addressing adherence in the clinic encounter is also fraught with challenges. Riekert et al administered a web-based survey of all programs accredited by the US CF Foundation, which showed that only 8% of respondents actually used any objective measures of adherence in clinic, and only 64% discussed adherence at each clinic visit 39. The most common strategy used to improve adherence was counseling based on education.…”

Section: Potential Strategies To Improve Adherencementioning

confidence: 99%

“…Clear behavioral techniques (such as motivational interviewing [MI] and therapy) are used less regularly. The barriers mentioned were limits in skills, staffing, time, and reimbursement 39. This remains an area ripe for future research studies, although the current literature has begun to address this gap.…”

Section: Potential Strategies To Improve Adherencementioning

confidence: 99%

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Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis

Bishay

Sawicki

2016

AHMT

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While development of new treatments for cystic fibrosis (CF) has led to a significant improvement in survival age, routine daily treatment for CF is complex, burdensome, and time intensive. Adolescence is a period of decline in pulmonary function in CF, and is also a time when adherence to prescribed treatment plans for CF tends to decrease. Challenges to adherence in adolescents with CF include decreased parental involvement, time management and significant treatment burden, and adolescent perceptions of the necessity and value of the treatments prescribed. Studies of interventions to improve adherence are limited and focus on education, without significant evidence of success. Smaller studies on behavioral techniques do not focus on adolescents. Other challenges for improving adherence in adolescents with CF include infection control practices limiting in-person interactions. This review focuses on the existing evidence base on adherence intervention in adolescents with CF. Future directions for efforts to optimize treatment adherence in adolescents with CF include reducing treatment burden, developing patient-driven technology to improve tracking, communication, and online support, and rethinking the CF health services model to include assessment of individualized adherence barriers.

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Section: Discussion and Future Directionsmentioning

confidence: 99%

Section: Known Barriers To Treatment Adherence In Adolescents With Cfmentioning

confidence: 99%

Section: Potential Strategies To Improve Adherencementioning

confidence: 99%

Section: Potential Strategies To Improve Adherencementioning

confidence: 99%

See 2 more Smart Citations

Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis

Bishay

Sawicki

2016

AHMT

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“…Poor adherence to these therapies can lead to increased hospital admissions, decreased pulmonary functioning, and shorter life spans. 6,13,14 In this era of new treatments and improved lifespans for patients with CF, 9,15 the importance of adherence cannot be underestimated.…”

Section: Introductionmentioning

confidence: 99%

Validation of a Cystic Fibrosis Medication Knowledge Questionnaire

FitzPatrick

Hawboldt

Smith

et al. 2017

Global Pediatric Health

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Low adherence to cystic fibrosis (CF) treatment is associated with poor health outcomes, while knowledge of the disease and medication regimen can positively influence adherence. This study’s purpose was to develop and validate a questionnaire to help determine CF medication knowledge of pediatric patients and caregivers. Our questionnaire had 37 items: 22 selected-response and 15 open-response questions. We used validation processes from the Standards for Educational and Psychological Testing. CF experts analyzed validity evidence based on content. Then, the questionnaire was field tested with 17 pediatric patients and 18 caregivers. The correlation between age and medication knowledge was medium (r = .33), but was not significant (P = .189). Cronbach’s α for the overall test was .84. Participants thought the questionnaire was important and suitable, with a few minor suggestions to improve wording. Strong validity evidence indicates the questionnaire could be used to assess medication knowledge and allow more personalized education to improve adherence.

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Tackling the increasing complexity of CF care

Sawicki

Goss

2015

Pediatric Pulmonology

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Summary Health outcomes for individuals with cystic fibrosis (CF) have dramatically improved in parallel with better organization of clinical care systems, evolution of novel therapeutics, and improvements in diagnosis and screening for CF and CF‐related complications. In parallel with these advances has come an increasing complexity and burden of care, leading to challenges with adherence to treatment regimens. As novel therapeutics continue to be developed and introduced to the CF care regimen, there are clear opportunities to refine and personalize care. This can be done by adding comparative effectiveness research to the CF clinical research paradigm and integrating novel technologies in drug delivery and remote monitoring that can facilitate adherence but also reduce the burden of treatment while maintaining efficacy. This review highlights both the challenges of the increasingly complex treatment regimens in CF and the opportunities to advance care by addressing adherence, implementation science, comparative effectiveness, and integration of novel technologies in CF care. Pediatr Pulmonol. 2015; 50:S74–S79. © 2015 Wiley Periodicals, Inc.

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Opportunities for cystic fibrosis care teams to support treatment adherence

Abstract: Many opportunities exist for care teams to improve consistency in adherence practices and integrate a greater repertoire of effective counseling strategies into clinic visits. Adherence promotion practices should be considered for quality improvement (QI) projects.

Cited by 38 publications

References 26 publications

Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis

Strategies to optimize treatment adherence in adolescent patients with cystic fibrosis

Validation of a Cystic Fibrosis Medication Knowledge Questionnaire

Tackling the increasing complexity of CF care

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