Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease

被引：16

作者：

Varni, James W. ^{[1
]}

Shulman, Robert J. ^{[2
]}

Self, Mariella M. ^{[3
,4
]}

Saeed, Shehzad A. ^{[5
]}

Zacur, George M. ^{[5
]}

Patel, Ashish S. ^{[6
]}

Nurko, Samuel ^{[7
]}

Neigut, Deborah A. ^{[8
]}

Franciosi, James P. ^{[5
]}

Saps, Miguel ^{[9
]}

Denham, Jolanda M. ^{[10
]}

Dark, Chelsea Vaughan ^{[11
]}

Bendo, Cristiane B. ^{[12
]}

Pohl, John F. ^{[13
]}

机构：

[1] Texas A&M Univ, Coll Architecture, Dept Landscape Architecture & Urban Planning, Dept Pediat,Coll Med, College Stn, TX 77843 USA

[2] Texas Childrens Hosp, Baylor Coll Med, Childrens Nutr Res Ctr, Dept Pediat, Houston, TX 77030 USA

[3] Texas Childrens Hosp, Baylor Coll Med, Dept Psychiat, Houston, TX 77030 USA

[4] Texas Childrens Hosp, Baylor Coll Med, Dept Pediat, Houston, TX 77030 USA

[5] Cincinnati Childrens Hosp Med Ctr, Div Gastroenterol Hepatol & Nutr, Cincinnati, OH 45229 USA

[6] Univ Texas Southwestern Med Sch, Childrens Med Ctr Dallas, Div Pediat Gastroenterol, Dallas, TX USA

[7] Harvard Med Sch, Boston Childrens Hosp, Ctr Motil & Funct Gastrointestinal Disorders, Boston, MA USA

[8] Childrens Hosp Colorado, Div Gastroenterol Hepatol & Nutr, Aurora, CO USA

[9] Northwestern Univ, Feinberg Sch Med, Lurie Childrens Hosp Chicago, Div Gastroenterol Hepatol & Nutr, Chicago, IL 60611 USA

[10] Nationwide Childrens Hosp, Div Gastroenterol Hepatol & Nutr, Columbus, OH USA

[11] Texas A&M Univ, Dept Psychol, College Stn, TX 77843 USA

[12] Univ Fed Minas Gerais, Fac Dent, Dept Pediat Dent & Orthodont, Belo Horizonte, MG, Brazil

[13] Univ Utah, Primary Childrens Hosp, Dept Pediat Gastroenterol, Salt Lake City, UT USA

来源：

QUALITY OF LIFE RESEARCH | 2018年 / 27卷 / 01期

基金：

美国国家卫生研究院;

关键词：

Inflammatory bowel disease; Crohn's disease; Ulcerative colitis; Gastrointestinal symptoms; Medication adherence barriers; Patient communication; PedsQL; ORAL MEDICATION; WORRY SCALES; ULCERATIVE-COLITIS; ADOLESCENTS; CHILDREN; PREDICTORS; THERAPY; IBD; RELIABILITY; RUMINATION;

D O I：

10.1007/s11136-017-1702-6

中图分类号：

R19 [保健组织与事业（卫生事业管理）];

学科分类号：

摘要：

The primary objective was to investigate the mediating effects of patient-perceived medication adherence barriers in the relationship between gastrointestinal symptoms and generic health-related quality of life (HRQOL) in adolescents with inflammatory bowel disease (IBD). The secondary objective explored patient health communication and gastrointestinal worry as additional mediators with medication adherence barriers in a serial multiple mediator model. The Pediatric Quality of Life Inventory (TM) Gastrointestinal Symptoms, Medicines, Communication, Gastrointestinal Worry, and Generic Core Scales were completed in a 9-site study by 172 adolescents with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, constipation, or diarrhea and perceived medication adherence barriers were tested for bivariate and multivariate linear associations with HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of perceived medication adherence barriers as an intervening variable between gastrointestinal symptoms and HRQOL. The predictive effects of gastrointestinal symptoms on HRQOL were mediated in part by perceived medication adherence barriers. Patient health communication was a significant additional mediator. In predictive analytics models utilizing multiple regression analyses, demographic variables, gastrointestinal symptoms (stomach pain, constipation, or diarrhea), and perceived medication adherence barriers significantly accounted for 45, 38, and 29 percent of the variance in HRQOL (all Ps < 0.001), respectively, demonstrating large effect sizes. Perceived medication adherence barriers explain in part the effects of gastrointestinal symptoms on HRQOL in adolescents with IBD. Patient health communication to healthcare providers and significant others further explain the mechanism in the relationship between gastrointestinal symptoms, perceived medication adherence barriers, and HRQOL.

引用

页码：195 / 204

页数：10

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