Pulmonary Medication Adherence and Health-care Use in Cystic Fibrosis

Quittner, Alexandra L.; Zhang, Jie; Marynchenko, Maryna; Chopra, Pooja; Signorovitch, James; Yushkina, Y.; Riekert, Kristin A.

doi:10.1378/chest.13-1926

Cited by 197 publications

(270 citation statements)

References 25 publications

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“…Child age was also included as a mediator because of the relationship between age and treatment adherence. 12,27,28 Robust SEs were generated by using resampling estimates derived from 2000 random draws. 29 Resampling estimates have been shown to be less biased and more powerful than other tests of indirect effects in samples <200.…”

Section: Discussionmentioning

confidence: 99%

Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis

Barker

Quittner

2016

Pediatrics

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Section: Discussionmentioning

confidence: 99%

Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis

Barker

Quittner

2016

Pediatrics

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“…Parental cystic fibrosis (CF) treatment adherence is variable, which is partly due to the complex and time-consuming daily treatment regimen (1,2). For most patients, the current accepted CF treatment regimen consists of a minimum of airway clearance therapy (ACT), chronic use of oral and nebulized medications (NMs), and pancreatic enzyme replacement with intermittent need for additional oral, nebulized, and occasional intravenous medications during acute illness.…”

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confidence: 99%

Adherence Determinants in Cystic Fibrosis: Cluster Analysis of Parental Psychosocial, Religious, and/or Spiritual Factors

et al. 2015

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Rationale: Cystic fibrosis is a progressive disease requiring a complex, time-consuming treatment regimen. Nonadherence may contribute to an acceleration of the disease process. Spirituality influences some parental healthcare behaviors and medical decision-making. Objectives:We hypothesized that parents of children with cystic fibrosis, when classified into groups based on adherence rates, would share certain psychosocial and religious and/or spiritual variables distinguishing them from other adherence groups.Methods: We conducted a multisite, prospective, observational study focused on parents of children younger than 13 years old at two cystic fibrosis center sites (Site 1, n = 83; Site 2, n = 59). Religious and/or spiritual constructs, depression, and marital adjustment were measured by using previously validated questionnaires. Determinants of adherence included parental attitude toward treatment, perceived behavioral norms, motivation, and self-efficacy. Adherence patterns were measured with the Daily Phone Diary, a validated instrument used to collect adherence data. Cluster analysis identified discrete adherence patterns, including parents' completion of more treatments than prescribed.Measurements and Main Results: For airway clearance therapy, four adherence groups were identified: median adherence rates of 23%, 52%, 77%, and 120%. These four groups differed significantly for parental depression, sanctification of their child's body, and self-efficacy. Three adherence groups were identified for nebulized medications: median adherence rates of 35%, 82%, and 130%. These three groups differed significantly for sanctification of their child's body and self-efficacy. Conclusions:Our results indicated that parents in each group shared psychosocial and religious and/or spiritual factors that differentiated them. Therefore, conversations about adherence likely should be tailored to baseline adherence patterns. Development of efficacious religious and/or spiritual interventions that promote adherence by caregivers of children with cystic fibrosis may be useful.

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“…Adherence to a complex treatment regimen is time consuming, intrusive and an often overwhelming responsibility [31,32]. Practical and psychosocial support has to be provided in parallel [33].…”

Section: Adherencementioning

confidence: 99%

Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

et al. 2015

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The improved survival in people with cystic fibrosis has led to an increasing number of patients reaching adulthood. This trend is likely to be maintained over the next decades, suggesting a need to increase the number of centres with expertise in the management of adult patients with cystic fibrosis. These centres should be capable of delivering multidisciplinary care addressing the complexity of the disease, in addition to addressing the psychological burden on patients and their families. Further issues that require attention are organ transplantation and end of life management.Lung disease in adults with cystic fibrosis drives most of the clinical care requirements, and major lifethreatening complications, such as respiratory infection, respiratory failure, pneumothorax and haemoptysis, and the management of lung transplantation require expertise from trained respiratory physicians. The taskforce therefore strongly reccommends that medical leadership in multidisciplinary adult teams should be attributed to a respiratory physician adequately trained in cystic fibrosis management.The task force suggests the implementation of a core curriculum for trainees in adult respiratory medicine and the selection and accreditation of training centres that deliver postgraduate training to the standards of the HERMES programme. @ERSpublications Respiratory physicians, trained in adult CF management, should lead multidisciplinary teams taking care of patients http://ow.ly/SgRgj

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Pulmonary Medication Adherence and Health-care Use in Cystic Fibrosis

Cited by 197 publications

References 25 publications

Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis

Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis

Adherence Determinants in Cystic Fibrosis: Cluster Analysis of Parental Psychosocial, Religious, and/or Spiritual Factors

Report of the European Respiratory Society/European Cystic Fibrosis Society task force on the care of adults with cystic fibrosis

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