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Phan H, Daines CL, Woo T, Psoter KJ, Goodman A, McWilliams E, Frederick C, Milla C, Oates G, Sawicki GS, Riekert KA. Development and preliminary validation of the personalized cystic fibrosis medication questionnaire (PCF-MQ). J Cyst Fibros 2024:S1569-1993(24)00073-0. [PMID: 38851920 DOI: 10.1016/j.jcf.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 05/10/2024] [Accepted: 05/20/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND A personalized approach to assessing medication knowledge may identify opportunities for education to support self-management of cystic fibrosis (CF). This project describes the development, scoring, and preliminary validity of the Personalized CF Medication Questionnaire (PCF-MQ), designed to assess knowledge of prescribed CF medication purpose, administration, and dose and frequency. METHODS Participants completed the PCF-MQ, the Knowledge of Disease Management (KDM-CF), and the Cystic Fibrosis-Medication Beliefs Questionnaire (CF-MBQ). Prescribed regimens were abstracted from medical records. Eligibility criteria were age 12 years and older, diagnosed with CF, and prescribed a CF medication. Statistical analyses were conducted using R software. Spearman rho was used to test correlations between measures. RESULTS Sixty people with CF (pwCF) were enrolled; three people reported a regimen that substantially deviated from the medical record and were excluded from the analyses. The mean (SD) age was 20.2 (7.3) years, 54 % were female, and 74 % had a FEV1pp ≥70 %. The mean (SD) PCF-MQ total score was 77.8 (12.3) and knowledge scores ranged from a low of 58.3 for levalbuterol to 100 for ivacaftor. The PCF-MQ total score correlated with the KDM total score and subscales (Spearman Rho= 0.32-0.59, p < 0.05) and was not correlated with the CF-MBQ subscales (p > 0.05)). CONCLUSIONS The PCF-MQ was correlated with another measure of general CF knowledge, but not health beliefs; because of the small sample size, this should be considered preliminary evidence of its validity. Advantages over existing CF knowledge measures include its practicality for use to help assess pwCF's knowledge about their prescribed regimen.
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Affiliation(s)
- Hanna Phan
- Department of Clinical Pharmacy, University of Michigan, College of Pharmacy, Michigan Medicine, C.S. Mott Children's Hospital, 428 Church Street, Ann Arbor, MI 48109, USA.
| | - Cori L Daines
- Department of Pediatrics, University of Arizona College of Medicine, Banner University Medical Center-Tucson, PO Box 245073, Tucson, AZ 85724, USA
| | - Ti Woo
- Department of Medicine, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Kevin J Psoter
- Department of Pediatrics, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Andrea Goodman
- Department of Medicine, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
| | - Emma McWilliams
- Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Carla Frederick
- Department of Pulmonary Medicine, University at Buffalo, 100 High St. B-8, Buffalo, NY 14203, USA
| | - Carlos Milla
- Department of Pediatrics - Pulmonary Medicine, Stanford University, 770 Welch Rd Suite 350, Stanford, CA 93405, USA
| | - Gabriela Oates
- Department of Pediatrics, 1600 7th Avenue South, Lowder 620, Birmingham, AL 35233, USA
| | - Gregory S Sawicki
- Department of Pediatrics, Boston Children's Hospital, 300 Longwood Avenue, Boston, MA 02115, USA
| | - Kristin A Riekert
- Department of Medicine, Johns Hopkins University, School of Medicine, 5501 Hopkins Bayview Circle, Baltimore, MD 21224, USA
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Harrigan M, Jessup M, Bennett K, Mulrennan S. Me, myself, and I: A systematic review of cystic fibrosis and self-concept. Pediatr Pulmonol 2024; 59:1175-1195. [PMID: 38376009 DOI: 10.1002/ppul.26916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/03/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
Given extensive pertinent disease factors and evolving medical treatments, this systematic review explores qualitative and quantitative cystic fibrosis (CF) research surrounding self-concept, an overarching perception of self. Research methodologies, self-concept dimensions, prominent self-concept findings and clinical recommendations are identified. Preferred Reporting Items for Systematic Review and Meta-analyses guidelines were applied. PubMed, Scopus, Medline, Psycinfo, CINAHL (ebsco), and CENTRAL Cochrane electronic databases were searched from 2012 to 2022. Methodological quality was assessed using the critical appraisal skills program. Data-based convergent synthesis was applied to analyze and report on qualitative and quantitative studies in parallel. Thirty-seven publications met the inclusion criteria, most of which employed a cross-sectional, single-center design within an adolescent and adult population. Self-efficacy, self-esteem, and self-identity studies were dimensions of self-concept identified, with studies relating to self-efficacy surrounding physical health management most prevalent. All three dimensions were positively associated with improved treatment adherence and psychosocial health. Efficacy tested intervention programs to enhance self-concept are limited; however, an extensive range of clinical recommendations are offered, highlighting the importance of clinician self-concept awareness, quality clinician-patient conversations and online CF peer-support. Self-concept is an important mechanism to optimize patient outcomes. Further CF self-concept research is required, particularly multicenter, longitudinal, and interventional studies. Early childhood, post lung transplant and the older adult CF population in particular, lack research attention. Given the potential impact of rapidly evolving CF transmembrane conductance regulator modulator drugs on many aspects of self, future self-concept research beyond the dimension of self-efficacy may be beneficial.
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Affiliation(s)
- Maggie Harrigan
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Institute for Respiratory Health (IRH), Perth, Western Australia, Australia
- Cystic Fibrosis Western Australia (CFWA), Perth, Western Australia
| | - Melanie Jessup
- School of Nursing, Midwifery and Social Work, The University of Queensl, Brisbane, Queensland, Australia
| | - Kellie Bennett
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
| | - Siobhain Mulrennan
- UWA Medical School, The University of Western Australia, Perth, Western Australia, Australia
- Institute for Respiratory Health (IRH), Perth, Western Australia, Australia
- Department of Respiratory Health, Sir Chares Gairdner Hospital (SCGH) Cystic Fibrosis Clinic, Perth, Western Australia, Australia
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Schellhaas SM, Ramsey RR. Commentary: JPP Student Journal Club Commentary: Knowledge as necessary but not sufficient for improving self-management in pediatric chronic illness. J Pediatr Psychol 2024:jsae028. [PMID: 38587874 DOI: 10.1093/jpepsy/jsae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/22/2024] [Accepted: 03/23/2024] [Indexed: 04/09/2024] Open
Affiliation(s)
- Sarah M Schellhaas
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
| | - Rachelle R Ramsey
- Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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Sun X, Gao Y, Chen Y, Qin L, Lin Y, Song J, Zhang Z, Wang H, Feng H, Tan H, Chen Q, Peng L, Dai W, Wu IXY. Development and validation of frailty and malnutrition knowledge assessment scale for community-dwelling older adults. Appl Physiol Nutr Metab 2023; 48:974-1004. [PMID: 37669568 DOI: 10.1139/apnm-2023-0141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
Abstract
There is a lack of reliable tools to assess the knowledge of frailty and malnutrition in community-dwelling older adults. To develop and validate reliable frailty and malnutrition knowledge assessment scales for this population, two scales were developed and validated through five phases. Phase 1: the item pools were constructed through a literature review and research panel based on the symptom interpretation model. Phase 2: the expert consultation was performed to select the items. Phase 3: a pilot survey was conducted to assess the clarity of the items and further revise the scales. Phase 4: 242 older adults were surveyed to finalize the items. Phase 5: 241 older adults were surveyed to test the psychometric properties. The two scales each comprise 3 dimensions (symptoms, risk factors, and management strategies) and 11 items. They had good construct validity, with all indicators of correlation analysis and confirmatory factor analysis meeting their specific criteria. The reliability of the frailty and malnutrition knowledge assessment scales was good, with composite reliability coefficients all >0.60, Cronbach's alpha being 0.81 and 0.83, and the Spearman-Brown coefficient being 0.74 and 0.80, respectively. Their acceptability was good, with both having a completion rate of 92.18% and an average completion time of 3 min. The two scales are reliable tools to assess the knowledge of frailty and malnutrition among community-dwelling older adults, especially for large-scale surveys. They can help identify knowledge gaps in older adults and provide a basis for developing targeted educational interventions.
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Affiliation(s)
- Xuemei Sun
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Yinyan Gao
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Yancong Chen
- Changsha Municipal Center for Disease Control and Prevention, Changsha, China
| | - Lang Qin
- Sinocare Inc., No. 265 Guyuan Road Hi-tech Zone, Changsha, Hunan, China
| | - Yali Lin
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Jinlu Song
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Zixuan Zhang
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Huan Wang
- Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China
| | - Hui Feng
- Xiangya Nursing School, Central South University, Changsha, China
| | - Hongzhuan Tan
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Qiong Chen
- Xiangya Hospital of Central South University, Changsha, China
| | - Linlin Peng
- Xiangya Hospital of Central South University, Changsha, China
| | - Wenjie Dai
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
| | - Irene X Y Wu
- Xiangya School of Public health, Central South University, Changsha, Hunan, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Changsha, China
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Zakeri MA, Tavan A, Nadimi AE, Bazmandegan G, Zakeri M, Sedri N. Relationship Between Health Literacy, Quality of Life, and Treatment Adherence in Patients with Acute Coronary Syndrome. Health Lit Res Pract 2023; 7:e71-e79. [PMID: 37053051 PMCID: PMC10104679 DOI: 10.3928/24748307-20230320-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Acute coronary syndrome is a significant global health concern that can affect patients' health outcomes and quality of life. In addition, adherence to treatment and health literacy can affect health outcomes. OBJECTIVE This study aimed to investigate the relationship between treatment adherence, health literacy, and quality of life among patients with acute coronary syndrome. METHODS This cross-sectional study was conducted on 407 patients in Iran from April 2019 to November 2019. Patients were selected by convenience sampling method. Data were collected using demographic questionnaire, World Health Organization Quality of Life Brief Version, Adherence to Treatment Questionnaire, and Health Literacy for Iranian Adults questionnaire. SPSS 25 was used for statistical analysis. RESULTS Based on descriptive statistics in this study, most of the participants had good treatment adherence level (56.5%); 28.7% of the participants had insufficient health literacy level. The mean score of quality of life was 51.41 ± 12.03, which was greater than the midpoint of the questionnaire. Furthermore, Pearson's correlation coefficient showed a negative association between health literacy, treatment adherence (r = -0.167, p < .01), and quality of life (r = -0.153, p < .01), and a positive association between treatment adherence and quality of life (r = 0.169, p < .01). CONCLUSION The results of the current study showed a negative relationship between health literacy, quality of life, and treatment adherence among patients with acute coronary syndrome. [HLRP: Health Literacy Research and Practice. 2023;7(2):e71-e79.].
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Affiliation(s)
| | | | | | | | | | - Nadia Sedri
- Address correspondence to Nadia Sedri, MSc, Nursing Research Center, Kerman University of Medical Sciences, Hapht Bagh St. 7616913555, Kerman, Iran;
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Reeves PT, Jack BO, Rogers PL, Kolasinski NT, Burklow CS, Min SB, Nylund CM. The Uniformed Services Constipation Action Plan: An Effective Tool for the Management of Children with Functional Constipation. J Pediatr 2023; 253:46-54.e1. [PMID: 36115625 DOI: 10.1016/j.jpeds.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To implement and to evaluate the effectiveness of the Uniformed Services Constipation Action Plan (USCAP) in our gastroenterology clinic for children with functional constipation. STUDY DESIGN This implementation science study included toilet-trained subjects aged 4 years and older who met the Rome IV criteria for functional constipation. Children were block randomized to receive either the USCAP or control. All clinic functional constipation plans recommended subjects continue pharmacotherapy for 4 months. Endpoints measured were clinical outcomes (resolution of functional constipation and achievement of a Pediatric Bristol Stool Form Scale [PBSFS] score of 3 or 4), patient-related outcomes (health-related quality of life [HRQoL] total scale score), and health confidence outcomes (Health Confidence Score [HCS]). RESULTS Fifty-seven treatment group subjects (44%) received a USCAP (52% male; mean age, 10.9 [4.9] years) compared with 73 controls (56%; 48% male; mean age,10.9 [5.3] years). A PBSFS score of 3 or 4 was achieved by 77% of the treatment group compared with 59% of controls (P = .03). Subjects from the treatment group were more likely than the controls to endorse adherence to the 4-month course of pharmacotherapy (P < .001). Subjects who received a USCAP had greater improvements in HRQoL total scale score by the end of the project (P = .04). CONCLUSIONS The USCAP is a simple, inexpensive tool that has the potential to improve global outcomes for functional constipation in children and should be recommended as standard clinical practice.
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Affiliation(s)
- Patrick T Reeves
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD; Department of Pediatrics, Brooke Army Medical Center, San Antonio, TX.
| | - Benjamin O Jack
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD
| | - Philip L Rogers
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Nathan T Kolasinski
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Carolyn Sullivan Burklow
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Steve B Min
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
| | - Cade M Nylund
- Department of Pediatrics, Walter Reed National Military Medical Center, Bethesda, MD; Department of Pediatrics, Uniformed Services University of the Health Sciences, Bethesda, MD
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Wang Y, Chen H, Cao J, Li M, Wang J, Jing R. Psychometric validation of the Chinese version of the Adolescent Asthma Self-Efficacy Questionnaire. Front Psychol 2022; 13:1013989. [PMID: 36619064 PMCID: PMC9814505 DOI: 10.3389/fpsyg.2022.1013989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Self-efficacy was considered as a promising target for the self-management of symptoms for adolescents with asthma. The measurement of self-efficacy in adolescents with asthma requires effective self-report tools, which have not been met with at present. So, the aim of this study was to cross-culturally validate the Adolescent Asthma Self-Efficacy Questionnaire (AASEQ). Methods As many as 408 adolescents with asthma were invited to take up the psychometric properties test between July 2021 and June 2022. We conducted the confirmatory factor analysis (CFA) to determine the structure of the AASEQ. The relationship between the AASEQ and General Self-Efficacy Scale was tested to evaluate the construct validity. The reliability was evaluated by retest reliability, internal consistency, and interfactor correlation. Results The results of the present study showed that the confirmatory factor analysis indicated a significantly good fit for a four-factor model, which explained 62.697% of the total variance. The fit indices of the four-factor model were acceptable, and the standardized factor loading ranged from 0.631 to 0.880. The C-AASEQ showed an acceptable internal consistency (Cronbach's α = 0.810-0.927) and test-retest reliability (intraclass correlation coefficient = 0.64-0.89). Content validity index at the scale level was 0.96, and content validity index at the item level was 0.86 to 1. Conclusion The Chinese version of Adolescent Asthma Self-Efficacy Questionnaire showed consistently acceptable positive psychometric properties and can be used as an instrument to assess the self-efficacy of adolescents with asthma in China, as corroborated in the present study.
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Affiliation(s)
- Yuanyuan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Hongyu Chen
- Department of Neurosurgery, The First Hospital of China Medical University, Shenyang, China
| | - Jinjin Cao
- Department of Gastroenterology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Mei Li
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China,*Correspondence: Mei Li ✉
| | - Jianan Wang
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ruochen Jing
- Department of Nursing, Children's Hospital of Nanjing Medical University, Nanjing, China
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Hatziagorou E, Manika K, Kyrvasili SS, Kotoulas SC, Chrysochoou EA, Kouroukli E, Sionidou M, Tsanakas J. Pulmonary medication adherence among children and adults with cystic fibrosis: Is there an association with disease severity? Pediatr Pulmonol 2022; 57:3017-3026. [PMID: 35997065 DOI: 10.1002/ppul.26126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 07/09/2022] [Accepted: 08/16/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND Adherence to pulmonary medication is pivotal in delaying the progression of lung disease in cystic fibrosis (CF). Further exploring the consequences of poor adherence and its impact on disease severity may be valuable to personalize CF treatment strategy. AIM To evaluate indicators of disease severity among children and adults with CF and investigate which of them are related to pulmonary medication adherence. METHODS This is a retrospective cohort study. Data of children and adults followed up in one pediatric and one adult CF Unit were evaluated over 4 years. Disease severity was assessed by measuring body mass index (BMI), lung function, history of pulmonary exacerbations, and medication complexity. Adherence was assessed by calculating a 12-month medication possession ratio (MPR) for each pulmonary medication and then averaged for a composite MPR (cMPR) for each patient. Regression analysis was performed to explore the association of adherence with disease severity. RESULTS Ninety-five patients were included in our study, 52 children and 43 adults. The overall cMPR was 0.74 (SD = 0.25); 0.68 (SD = 0.24) for children and 0.81 (SD = 0.24) for adults. Adults presented higher adherence, with overall mean cMPR 0.81 (SD = 0.24) compared to children with mean cMPR 0.68 (SD = 0.24) (p < 0.05, 95% CI = -0.27 to -0.03). Adherence was inversely related to FEV1 % predicted (β = -0.002, 95% CI = -0.004 to 0, p = 0.023) and FVC% predicted (β = -0.003, 95% CI = -0.005 to -0.001, p = 0.006) in regression analysis. Adherence was not found to be associated with BMI, history of exacerbations and medication complexity. The analysis of each medication showed that adherence to Dornase-alpha, Tobramycin and Colomycin was significantly related to specific disease severity indicators. CONCLUSION An overall moderate to high level of adherence was found among our study population. Adults presented higher adherence compared to children. FEV1% and FVC% predicted were related to a significant decrease in adherence. Among our group of CF patients with an overall moderate to high level of adherence, adherence to pulmonary medication was inversely related to disease severity.
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Affiliation(s)
- Elpis Hatziagorou
- Cystic Fibrosis Unit, 3rd Paediatric Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Katerina Manika
- Adult Cystic Fibrosis Unit, Pulmonary Department, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Exohi, Thessaloniki, Greece
| | - Syrmo Styliani Kyrvasili
- Cystic Fibrosis Unit, 3rd Paediatric Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Serafeim Chrysovalantis Kotoulas
- Adult Cystic Fibrosis Unit, Pulmonary Department, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Exohi, Thessaloniki, Greece
| | - Elisavet Anna Chrysochoou
- Cystic Fibrosis Unit, 3rd Paediatric Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleana Kouroukli
- Cystic Fibrosis Unit, 3rd Paediatric Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Maria Sionidou
- Adult Cystic Fibrosis Unit, Pulmonary Department, "G. Papanikolaou" Hospital, Aristotle University of Thessaloniki, Exohi, Thessaloniki, Greece
| | - John Tsanakas
- Cystic Fibrosis Unit, 3rd Paediatric Department, "Hippokration" Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Comment améliorer la transition au sein des CRCM : analyse des besoins des patients et de leurs parents lors de l’arrivée en service adulte. Rev Mal Respir 2022; 39:132-139. [DOI: 10.1016/j.rmr.2022.01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 12/22/2021] [Indexed: 11/20/2022]
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Monteiro KS, Santino TA, Pakhale S, Balfour L, Pereira Pinto de Mendonça KM. Translation, cross-cultural adaptation and psychometric evaluation of the Brazilian version of the Cystic Fibrosis Knowledge Scale (CFKS). PLoS One 2021; 16:e0259232. [PMID: 34784376 PMCID: PMC8594816 DOI: 10.1371/journal.pone.0259232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 10/17/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Information on the level of knowledge about cystic fibrosis (CF) among affected people and their families is still scarce. OBJECTIVE This study aimed to translate, cross-culturally adapt and analyze the psychometric properties of the Brazilian version of Cystic Fibrosis Knowledge Scale (CFKS). MATERIALS AND METHODS The translation and cross-cultural adaptation involved the stages of translation, synthesis of translations, reverse translation, synthesis of reverse translations, review by a multi-professional committee of experts and pre-testing. The reliability, viability, construct, predictive, concurrent and discriminant validity were investigated. RESULTS The sample consisted of 40 individuals with cystic CF, 47 individuals with asthma, 242 healthcare workers and 81 students from the health area. The Brazilian version of the CFKS presented high internal consistency (α = 0.91), moderate floor and ceiling effects, without differences in the test-retest scores. An analysis of factorial exploration identified three dimensions. Confirmatory factor analysis led to an acceptable data-model fit. There was good predictive validity, with a difference in the scores among all the evaluated groups (p <0.001), as well as good discriminant validity since individuals with asthma had greater knowledge of asthma compared to CF (r = 0.401, p = 0.005; r2 = 0.162). However, there was no difference between the diagnosis time and knowledge about CF (r = -0.25, p = 0.11; r2 = 0.06), either between treatment adherence and knowledge about CF (r = -0.04, p = 0.77; r2 = 0.002). CONCLUSION The Brazilian version of the CFKS indicated that the scale is able to provide valid, reliable and reproducible measures for evaluating the knowledge about CF.
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Affiliation(s)
- Karolinne Souza Monteiro
- Faculty of Health Science of Trairi, Federal University of Rio Grande do Norte, Santa Cruz, Brazil
- * E-mail:
| | - Thayla Amorim Santino
- Graduate Program of Physical Therapy, Federal University of Rio Grande do Norte, Natal, Brazil
| | - Smita Pakhale
- Faculty of Medicine, University of Ottawa, Ottawa, Canadá
| | - Louise Balfour
- Faculty of Medicine, University of Ottawa, Ottawa, Canadá
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Tersigni C, Boiardi G, Tofani L, Venturini E, Montagnani C, Bortone B, Bianchi L, Chiappini E, Cassetta MI, Fallani S, Novelli A, Galli L. Real-life isoniazid and rifampicin plasma concentrations in children: a tool for therapeutic drug monitoring of tuberculosis. BMC Infect Dis 2021; 21:1087. [PMID: 34674665 PMCID: PMC8529739 DOI: 10.1186/s12879-021-06764-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 05/17/2021] [Indexed: 11/18/2022] Open
Abstract
Background Low plasma levels of first-line antitubercular drugs can be counted among the main causes of poor response to antitubercular therapy, and therapeutic drug monitoring has been proposed as a method to promote tailored treatments for both child and adult patients. The main aim of the study was to evaluate serum concentrations of isoniazid (INH) and rifampicin (RIF) and to investigate reasons for sub-therapeutic plasma concentrations in order to fix dosages. Methods Children with TB were prospectively enrolled from January to August 2019. Two venous blood samples were collected (the first at least 15 days after the beginning of antitubercular treatment, and the second between 1 and 8 weeks later). Plasma concentrations were determined by a validated high-performance liquid chromatography method. Results In all, 45 children were included. Seventy blood samples for INH plasma concentration were collected between 120 and 240 min after drug intake. Adjusting for dose (mg/kg/day) and time of INH administration, when considering three different age groups (≤ 2 years, 2–12 years, > 12 years), a statistically significant lower INH plasma concentration was observed in younger children compared to the older age groups in the multivariate analysis (p < 0.001 and p < 0.001). A total of 68 blood samples were evaluated for RIF concentrations. Both for INH and RIF a statistically significant lower plasma concentration was also observed in adolescents (p < 0.001). Fifteen children (15/45, 33%) presented drug concentrations under the referral therapeutic range. Conclusions Based on our findings, monitoring patients’ drug plasma concentrations in children under 2 years of age and in adolescents can make treatment more patient-tailored.
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Affiliation(s)
- Chiara Tersigni
- Post Graduate School of Pediatrics, University of Florence, Florence, Italy
| | | | - Lorenzo Tofani
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Florence, Florence, Italy
| | | | - Carlotta Montagnani
- Infectious Diseases Unit, Meyer Children's University Hospital, Florence, Italy
| | - Barbara Bortone
- Infectious Diseases Unit, Meyer Children's University Hospital, Florence, Italy
| | - Leila Bianchi
- Infectious Diseases Unit, Meyer Children's University Hospital, Florence, Italy
| | - Elena Chiappini
- Infectious Diseases Unit, Meyer Children's University Hospital, Florence, Italy.,Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy
| | - Maria Iris Cassetta
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Florence, Florence, Italy
| | - Stefania Fallani
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Florence, Florence, Italy
| | - Andrea Novelli
- Department of Health Sciences, Clinical Pharmacology and Oncology Section, University of Florence, Florence, Italy
| | - Luisa Galli
- Infectious Diseases Unit, Meyer Children's University Hospital, Florence, Italy. .,Department of Health Sciences, University of Florence, Anna Meyer Children's University Hospital, Florence, Italy.
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12
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Collins R, Singh B, Payne DN, Bharat C, Noffsinger W, Dhaliwal SS, O'Dea C, Mulrennan S. Effect of transfer from a pediatric to adult cystic fibrosis center on clinical status and hospital attendance. Pediatr Pulmonol 2021; 56:2029-2035. [PMID: 33793092 DOI: 10.1002/ppul.25398] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 03/24/2021] [Accepted: 03/27/2021] [Indexed: 11/06/2022]
Abstract
AIM Transfer from pediatric to adult services could lead to clinical deterioration, few studies have examined this. We sought to examine the clinical impact of a structured individualized transition and transfer process in patients with cystic fibrosis (CF). METHODS Medical records of all patients with CF in Western Australia who transferred from a pediatric center (Princess Margaret Hospital for Children) to an adult CF center (Sir Charles Gairdner Hospital) between 2008 and 2012 were reviewed. Data were extracted for 2 years before and after transfer. The number of CF outpatient visits, inpatient days, and home intravenous antibiotic therapy (HIVT) days were recorded at yearly intervals before and after transfer. Sputum culture results at transfer were collected. All respiratory function and anthropometric data over the 4 years were extracted. RESULTS Forty-two patients with CF were transferred between 2008 and 2012. The mean age at transfer was 18.9 years (range 17-22). Compared to 1-year pre-transfer, the frequency of outpatient visits at 1- and 2-year post-transfer increased. After transfer, there was no change in BMI, HIVT days, or inpatient days, and no acceleration in the expected decline in FEV1. CONCLUSION This study found that transfer from a pediatric to an adult CF center using a structured, individualized transition and transfer process was not associated with accelerated clinical deterioration.
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Affiliation(s)
- Rachel Collins
- Department of General Paediatrics, Perth Children's Hospital, Nedlands, Western Australia, Australia
| | - Bhajan Singh
- Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,West Australian Sleep Disorders Research Institute, Perth, Western Australia, Australia.,School of Human Sciences, University of Western Australia, Perth, Western Australia, Australia
| | | | - Chrianna Bharat
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - William Noffsinger
- Department of Pulmonary Physiology & Sleep Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia
| | - Satvinder S Dhaliwal
- Curtin Health Innovation Research Institute, Curtin University, Bentley, Western Australia, Australia.,Duke-NUS Medical School, National University of Singapore, Singapore, Singapore
| | - Christopher O'Dea
- Department of Respiratory Medicine, Perth Children's Hospital, Perth, Western Australia, Australia
| | - Siobhain Mulrennan
- Department of Respiratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.,Faculty of Health and Medical Sciences, University of Western Australia, Perth, Australia
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Abstract
Millions of children and adolescents are living with a chronic condition. It is common for mental and behavioral health challenges to arise during their courses of illness. With the complexity of care needed, pediatric subspecialty providers have recognized the need to integrate behavioral health interventions into practice. Continued research in this area has allowed for focused behavioral interventions, particularly in diabetes and asthma. Adult congenital heart programs have adapted a similar model of care and have shown promising success in promotion of health. More established programs have been in existence for childhood cancer and cystic fibrosis.
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Affiliation(s)
- Ethel Clemente
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA.
| | - Gordon Liu
- Western Michigan University, Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
| | - Maria Demma Cabral
- Department of Pediatric and Adolescent Medicine, Western Michigan University, Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI 49008-1284, USA
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14
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Abraham O, LeMay S, Nixon G, Braun A, Decker C, Szela L. Characterizing medication management and the role of pharmacists in caring for people living with cystic fibrosis: A work system approach. J Am Pharm Assoc (2003) 2021; 61:547-554.e2. [PMID: 33931354 DOI: 10.1016/j.japh.2021.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 03/19/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Cystic fibrosis (CF) is an autosomal recessive genetic disease requiring complex, lifelong medication regimens. Given the importance of medication in CF treatment, pharmacists are vital CF care team members in the care of people living with CF (PwCF). OBJECTIVES This study aimed to (1) define patients' CF medication experiences and educational needs and (2) investigate the CF outpatient clinic and community pharmacist's role in addressing patient challenges. METHODS A work system approach informed by the Systems Engineering Initiative for Patient Safety (SEIPS) model was used to characterize knowledge and perception of CF medication regimens, educational modalities, and pharmacist interactions for PwCF. Semistructured interviews were conducted with adults living with CF at a CF center clinic. Data analyses identified relationships between the themes in the data and 4 SEIPS work system domains: tasks, tools and technology, person, and environment. RESULTS Thirty PwCF interviews highlighted 4 themes regarding health care experiences: (1) medication use experience, (2) medication education needs, (3) disease experience, and (4) pharmacist and pharmacy interactions. Patients reported complex medication regimens leading to challenges with medication adherence, although the benefit of treatment was recognized. Although a high level of disease-state knowledge was identified among the participants, PwCF desired to learn about CF medication benefits and adverse effects through credible sources using multiple modalities. Many reported a benefit of pharmacist involvement in their care. CONCLUSION Pharmacists are well-positioned to support PwCF in adherence, medication regimen management, and medication education. Opportunities exist for growth in these supportive roles of a pharmacist in both community and outpatient clinic settings.
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15
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Torun T, Çavuşoğlu H, Doğru D, Özçelik U, Ademhan Tural D. The Effect of Self-Efficacy, Social Support and Quality of Life on Readiness for Transition to Adult Care Among Adolescents with Cystic Fibrosis in Turkey. J Pediatr Nurs 2021; 57:e79-e84. [PMID: 33279319 DOI: 10.1016/j.pedn.2020.11.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/22/2020] [Accepted: 11/22/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The aim of this study is to examine the effects of self-efficacy, social support and quality of life on readiness for transition to adult care in adolescents with cystic fibrosis. DESIGN AND METHODS A descriptive and cross-sectional study design was used. Data were collected from 50 adolescent between 14 and 17 years old with cystic fibrosis, by using The Transition Readiness Assessment Questionnaire, Social Support Appraisals Scale for Children, Self-Efficacy Questionnaire for Children and health-related quality-of-life instrument, the KIDSCREEN-10. RESULTS A positive correlation was found between the readiness levels of adolescents for transition to adult care and self-efficacy levels. In path analysis, self-efficacy was found to have a significant effect on the level of readiness for transition to adult care. There was not statistically significant relationship between the level of readiness for transition to adult care and health-related quality of life and perceived social support. Path analysis revealed that health-related quality of life and perceived social support had significant effects on the self-efficacy levels of adolescents. CONCLUSIONS Self-efficacy were associated with readiness for the transition to adult care. Although perceived social support and quality of life were not related with transition readiness these variables had significant effects on perceived self-efficacy, which was determined as a factor affecting the readiness for the transition to adult care. PRACTICE IMPLICATIONS In adolescents with cystic fibrosis, self-efficacy, social support and quality of life levels should be taken into account when planning preparation programs for transition to adult care.
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Affiliation(s)
- Tuğçe Torun
- Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Turkey.
| | - Hicran Çavuşoğlu
- Head of Pediatric Nursing Department, Faculty of Nursing, Hacettepe University, Turkey
| | - Deniz Doğru
- Pediatric Pulmonology Department, Faculty of Medicine, Hacettepe University, Turkey
| | - Uğur Özçelik
- Pediatric Pulmonology Department, Faculty of Medicine, Hacettepe University, Turkey
| | - Dilber Ademhan Tural
- Pediatric Pulmonology Department, Faculty of Medicine, Hacettepe University, Turkey
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16
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Eaton CK, Beachy S, McLean KA, Nicolais CJ, Bernstein R, Sáez-Clarke E, Quittner AL, Riekert KA. Misunderstandings, misperceptions, and missed opportunities: Perspectives on adherence barriers from people with CF, caregivers, and CF team members. PATIENT EDUCATION AND COUNSELING 2020; 103:1587-1594. [PMID: 32098744 DOI: 10.1016/j.pec.2020.02.025] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 01/24/2020] [Accepted: 02/15/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To identify differences in perspectives of people with cystic fibrosis (PwCF) and caregivers versus healthcare providers on adherence barriers. Mismatched perspectives may lead to miscommunication and missed opportunities to reduce barriers and improve CF outcomes. METHODS PwCF, caregivers, and CF providers completed audio-taped, semi-structured interviews about adherence barriers. Interviews were transcribed and coded for themes. Themes were reviewed to identify when PwCF-caregiver perspectives differed from providers'. RESULTS Participants included 14 adolescents with CF (mean age = 15.89 years, 64 % female, 71 % Caucasian), 14 adults with CF (mean age = 30.03 years, 64 % female, 57 % Caucasian), 29 caregivers (76 % female; 72 % Caucasian), and 42 providers. Four barriers were identified that could generate miscommunication between PwCF-caregivers and providers: Tired = Fatigued/Sleepy versus Tired = Burnout, Vacation and Travel, Knowledge and Skills About CF Regimen, and Daily Habits or Routines. PwCF and caregivers used similar words as providers, but conceptualized barriers differently. PwCF and caregivers discussed barriers pragmatically, however, providers viewed certain barriers more abstractly or unidimensionally, or did not discuss them. CONCLUSIONS PwCF-caregivers and providers may not align in how they discuss barriers, which may contribute to miscommunication about adherence challenges. PRACTICE IMPLICATIONS Patient-centered communication strategies may enhance providers' understandings of PwCF-caregiver perspectives on barriers and facilitate adherence interventions.
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Affiliation(s)
- Cyd K Eaton
- The Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA.
| | - Sara Beachy
- The Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
| | - Katherine A McLean
- Rush University Medical Center, Department of Pediatrics, Chicago, IL, USA
| | | | - Ruth Bernstein
- University of Miami, Department of Psychology, Coral Gables, FL, 33124, USA
| | | | | | - Kristin A Riekert
- The Johns Hopkins University School of Medicine, Department of Medicine, Baltimore, MD, USA
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17
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Chua B, Morgan J, Yap KZ. Refill Adherence Measures and Its Association with Economic, Clinical, and Humanistic Outcomes Among Pediatric Patients: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2133. [PMID: 32210111 PMCID: PMC7142643 DOI: 10.3390/ijerph17062133] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 03/20/2020] [Accepted: 03/21/2020] [Indexed: 12/23/2022]
Abstract
Although refill adherence measures (RAMs) are widely reviewed on their use among adult patients, existing reviews on adherence among children have only focused on self-report measures and electronic monitoring. Hence, this systematic review aims to examine the use of RAMs and their association with economic, clinical, and humanistic outcomes (ECHO) among pediatric patients. A literature search was conducted in Pubmed, Embase, CINAHL, and PsycINFO. Studies published in English involving subjects aged ≤18 years were included if RAMs were analyzed with ECHO. Of the 35 included studies, the majority (n = 33) were conducted in high-income countries. Asthma was the most common condition (n = 9) studied. Overall, 60.6% of 33 clinical outcomes reported among 22 studies was positive (improved clinical outcomes with improved adherence), while 21.9% of 32 economic outcomes reported among 16 studies was positive (reduced healthcare utilization or cost outcomes with improved adherence). Only four studies evaluated the relationship of adherence with 11 humanistic outcomes, where the majority (72.7%) were considered unclear. RAMs are associated with ECHO and can be considered for use in the pediatric population. Future studies could explore the use of RAMs in low-income countries, and the association of RAMs with quality of life.
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Affiliation(s)
- Brandon Chua
- Department of Pharmacy, KK Women’s and Children’s Hospital, 100 Bukit Timah Road, Singapore 229899, Singapore;
| | - James Morgan
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore;
| | - Kai Zhen Yap
- Department of Pharmacy, National University of Singapore, 18 Science Drive 4, Singapore 117543, Singapore;
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18
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Muther EF, Butcher JL, Riekert KA. Understanding Treatment Adherence in Cystic Fibrosis: Challenges and Opportunities. Respir Med 2020. [DOI: 10.1007/978-3-030-42382-7_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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19
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Bell SC, Mall MA, Gutierrez H, Macek M, Madge S, Davies JC, Burgel PR, Tullis E, Castaños C, Castellani C, Byrnes CA, Cathcart F, Chotirmall SH, Cosgriff R, Eichler I, Fajac I, Goss CH, Drevinek P, Farrell PM, Gravelle AM, Havermans T, Mayer-Hamblett N, Kashirskaya N, Kerem E, Mathew JL, McKone EF, Naehrlich L, Nasr SZ, Oates GR, O'Neill C, Pypops U, Raraigh KS, Rowe SM, Southern KW, Sivam S, Stephenson AL, Zampoli M, Ratjen F. The future of cystic fibrosis care: a global perspective. THE LANCET RESPIRATORY MEDICINE 2020; 8:65-124. [DOI: 10.1016/s2213-2600(19)30337-6] [Citation(s) in RCA: 351] [Impact Index Per Article: 87.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Revised: 07/19/2019] [Accepted: 08/14/2019] [Indexed: 02/06/2023]
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20
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Smaldone A, Manwani D, Green NS. Greater number of perceived barriers to hydroxyurea associated with poorer health-related quality of life in youth with sickle cell disease. Pediatr Blood Cancer 2019; 66:e27740. [PMID: 30941907 PMCID: PMC6538386 DOI: 10.1002/pbc.27740] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 02/28/2019] [Accepted: 03/12/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Despite medical benefits, hydroxyurea adherence in adolescents is often poor. As part of a baseline assessment of 28 youth (10-18 years) parent dyads who participated in a 6-month feasibility trial to improve hydroxyurea adherence, we measured the relationship between greater barriers to adherence and health-related quality of life (HRQL) from youth and parent perspectives. PROCEDURE Barriers were measured using the Adolescent and Parent Medication Barriers Scales with nine hydroxyurea items added. Barriers reported by ≥25% of the sample were considered common. Generic and disease-specific HRQL were measured by PedsQL and PedsQL Sickle Cell Disease modules. Data were analyzed using descriptive statistics, Cronbach alpha, Spearman correlation coefficients, and paired t tests. RESULTS Fifty-six subjects (28 dyads) participated. Youth reported greater barriers compared with parents (5.0 ± 3.9 and 3.5 ± 3.2; P = 0.03), with >80% of respondents reporting ≥1 barriers. Twelve barriers were reported by ≥25% of adolescents, whereas six were reported by ≥25% of parents. Of these, only two were common to both dyad members. Approximately one-third of youth had generic and disease-specific HRQL scores that fell at or below cutoff scores, suggesting being at risk for impaired HRQL. Greater barriers were inversely associated with poorer generic (parent r = -0.43, P = 0.03; youth r = -0.44, P < 0.001) and disease-specific HRQL (parent r = -0.53, P = 0.005; youth r = -0.53, P < 0.001). CONCLUSIONS Hydroxyurea barriers were frequently reported but differed by dyad members' perspective. Greater barriers were associated with poorer generic and disease-specific HRQL. To reduce barriers to hydroxyurea in youth with sickle cell disease, perspectives of both dyad members should be addressed.
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Affiliation(s)
- Arlene Smaldone
- Columbia University School of Nursing, New York, New York
- College of Dental Medicine, Columbia University Medical Center, New York, New York
| | - Deepa Manwani
- Department of Pediatrics, Albert Einstein College of Medicine, New York, New York
| | - Nancy S. Green
- Department of Pediatrics, Columbia University Medical Center, New York, New York
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21
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Travlos V, Downs J, Wilson A, Hince D, Patman S. Mental wellbeing in non-ambulant youth with neuromuscular disorders: What makes the difference? Neuromuscul Disord 2019; 29:48-58. [DOI: 10.1016/j.nmd.2018.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2018] [Revised: 07/29/2018] [Accepted: 08/29/2018] [Indexed: 01/14/2023]
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22
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Rouzé H, Viprey M, Allemann S, Dima AL, Caillet P, Denis A, Poupon-Bourdy S, Camara B, Llerena C, Reix P, Durieu I, Reynaud Q, Touzet S. Adherence to long-term therapies in cystic fibrosis: a French cross-sectional study linking prescribing, dispensing, and hospitalization data. Patient Prefer Adherence 2019; 13:1497-1510. [PMID: 31564837 PMCID: PMC6732572 DOI: 10.2147/ppa.s211769] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2019] [Accepted: 07/20/2019] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Cystic fibrosis (CF) is a life-shortening genetic condition that usually affects several organs and involves significant treatment burden. Adherence to medication is important for successful CF management. OBJECTIVE To describe medication adherence according to age, therapeutic class, and pharmaceutical form in adults and children followed in four regional CF centers in France. METHODS We conducted a cross-sectional study with non-transplanted patients followed in two adult and two pediatric centers during 2015 who were covered by the French National Health Insurance (NHI). Sociodemographic, clinical, hospitalization, and prescription data were collected from patient medical records. Medication dispensations were extracted from the regional French NHI database. Adherence was calculated over 12 months using continuous medication availability (CMA) accounting for dose adjustments and hospitalizations. Drug-specific CMA was computed in R with the AdhereR package for each medication prescribed more than 3 months, which was averaged to obtain a composite CMA score (cCMA) for all treatments and per therapeutic class as well as pharmaceutical form for each patient. RESULTS A total of 228 patients were included. The number of chronic medications increased with age (r=0.50, p<0.001): a median of 7 medications per patient were prescribed. The mean±SD cCMA was significantly different between age groups (p=0.0098): it was 0.71±0.20 for the 0-5 years age group, 0.73±0.16 for 6-11 years, 0.64±0.17 for 12-17 years, 0.57±0.23 for 18-25 years, and 0.65±0.20 for the over 25 years age group. cCMA varied significantly according to pharmaceutical forms: the mean±SD cCMA was 0.70±0.21 for oral medications and 0.54±0.28 for inhaled medications (p<0.001). CONCLUSION This study suggests that adherence to medication regimens in CF patients remains suboptimal and varies substantially between age groups and pharmaceutical forms. These variations in adherence should be considered when developing effective strategies to improve adherence.
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Affiliation(s)
- Héloïse Rouzé
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
- Correspondence: Héloïse RouzéHospices Civils de Lyon, Pôle de Santé Publique, Bâtiment A, 6ème étage, 162 Avenue Lacassagne69003Lyon, FranceTel +33 47 211 5132Email
| | - Marie Viprey
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
| | - Samuel Allemann
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
| | - Alexandra L Dima
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
| | - Pascal Caillet
- Department of Clinical Pharmacology, CHU de Nantes, Nantes, France
| | - Angélique Denis
- Public Health Department, Hospices Civils de Lyon, Lyon, France
| | | | - Boubou Camara
- Pulmonary Department, Adult CF Center, CHU de Grenoble, Grenoble, France
| | - Catherine Llerena
- Pediatric Pulmonology Department, Pediatric CF Center, CHU de Grenoble, Grenoble, France
| | - Philippe Reix
- Pediatric Pulmonology Department, Pediatric CF Center, Hôpital Femme-Mère-Enfant, Hospices Civils de Lyon, Lyon, France
| | - Isabelle Durieu
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Quitterie Reynaud
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
- Department of Internal Medicine, Adult Cystic Fibrosis Care Center, Centre Hospitalier Lyon Sud, Hospices Civils de Lyon, Lyon, France
| | - Sandrine Touzet
- Public Health Department, Hospices Civils de Lyon, Lyon, France
- HESPER Lab-EA 7425, Université de Lyon-Université Claude Bernard Lyon 1, Lyon, France
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Lonabaugh KP, O'Neal KS, McIntosh H, Condren M. Cystic fibrosis-related education: Are we meeting patient and caregiver expectations? PATIENT EDUCATION AND COUNSELING 2018; 101:1865-1870. [PMID: 29910140 DOI: 10.1016/j.pec.2018.06.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE The purpose of this study was to improve patient education in clinic by evaluating patient perceptions of education provided, as well as patient self-confidence related to topics within cystic fibrosis (CF). The study assessed whether self-confidence matched knowledge and defined patient-specific goals for education timing and information sources. METHODS Age specific questionnaires were distributed over four months to patients 11 years of age and older and caregivers of patients of all ages at a single CF Foundation accredited care center. RESULTS Participants reported frequent education on all topics except for reproductive effects of CF and mental health. A positive correlation was seen between overall confidence in CF-related knowledge and performance on a validated knowledge scale in adolescent caregivers only. Participants expected all educational milestones to be met by 13-14 years of age. CONCLUSIONS Gaps in CF education remain and educational models should deliver information by the early teens without overlooking reproductive effects and mental health. PRACTICE IMPLICATIONS The educational model for CF clinics should become more comprehensive by including education on topics such as mental health and reproductive effects. Providers are an important pathway for information and should not disregard the value of education provided during clinic visits.
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Affiliation(s)
- Kevin P Lonabaugh
- College of Pharmacy, University of Oklahoma-Tulsa, 4502 E 41(st) St, Tulsa, OK, 74135, USA.
| | - Katherine S O'Neal
- College of Pharmacy, University of Oklahoma-Tulsa, 4502 E 41(st) St, Tulsa, OK, 74135, USA
| | - Heather McIntosh
- School of Community Medicine, University of Oklahoma-Tulsa, 4502 E 41(st) St, Tulsa, OK, 74135, USA; Office for Research Development and Scholarly Activity, University of Oklahoma-Tulsa, 4502 E 41(st) St, Tulsa, OK, 74135, USA
| | - Michelle Condren
- School of Community Medicine, University of Oklahoma-Tulsa, 4502 E 41(st) St, Tulsa, OK, 74135, USA
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Lanzkron S, Sawicki GS, Hassell KL, Konstan MW, Liem RI, McColley SA. Transition to adulthood and adult health care for patients with sickle cell disease or cystic fibrosis: Current practices and research priorities. J Clin Transl Sci 2018; 2:334-342. [PMID: 30828476 PMCID: PMC6390387 DOI: 10.1017/cts.2018.338] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Revised: 10/28/2018] [Accepted: 10/29/2018] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION A growing population of adults living with severe, chronic childhood-onset health conditions has created a need for specialized health care delivered by providers who have expertise both in adult medicine and in those conditions. Optimal care of these patients requires systematic approaches to healthcare transition (HCT). Guidelines for HCT exist, but gaps in care occur, and there are limited data on outcomes of HCT processes. METHODS The Single Disease Workgroup of the Lifespan Domain Task Force of the National Center for Advancing Translational Sciences Clinical and Translational Science Award programs convened a group to review the current state of HCT and to identify gaps in research and practice. Using cystic fibrosis and sickle cell disease as models, key themes were developed. A literature search identified general and disease-specific articles. We summarized key findings. RESULTS We identified literature characterizing patient, parent and healthcare provider perspectives, recommendations for transition care, and barriers to effective transition. CONCLUSIONS With increased survival of patients with severe childhood onset diseases, ongoing study of effective transition practices is essential as survival increases for severe childhood onset diseases. We propose pragmatic methods to enhance transition research to improve health and key outcomes.
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Affiliation(s)
- Sophie Lanzkron
- Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Kathryn L. Hassell
- Department of Medicine, Division of Hematology, Colorado Sickle Cell Treatment and Research Center, University of Colorado, Aurora, CO, USA
| | - Michael W. Konstan
- Department of Pediatrics, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Robert I. Liem
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Susanna A. McColley
- Department of Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
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25
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Shakkottai A, Kaciroti N, Kasmikha L, Nasr SZ. Impact of home spirometry on medication adherence among adolescents with cystic fibrosis. Pediatr Pulmonol 2018; 53:431-436. [PMID: 29457700 DOI: 10.1002/ppul.23950] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 12/21/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Medication adherence among adolescents with cystic fibrosis (CF) is often suboptimal and this has significant impact on their health and quality of life. The purpose of the study was to evaluate the impact of frequent home pulmonary function (PFT) monitoring on medication adherence among adolescents with CF. HYPOTHESIS We hypothesized that weekly home PFT monitoring will improve adherence while not significantly adding to the treatment burden. METHODS Individuals aged 12-21 years with CF were provided a spirometer to measure PFTs weekly for 1 year. Results were reviewed weekly via telephone. PFT data were downloaded from the device during quarterly clinic visits. Adherence was calculated from prescription refill data and compared to the previous year. Perceptions of treatment burden were assessed using the CF questionnaire-revised (CFQ-R) quality of life measure. Health outcome measures including nutritional status and PFTs from clinic were collected for the study period and the year prior. RESULTS Thirty-nine subjects participated in the study. Mean age was 15.89 ± 2.18 years and 54% were female. Mean adherence to weekly spirometry monitoring was 59.47 ± 24.60%. Values generated on the device showed good correlation with those obtained in clinic. Mean medication possession ratio (MPR) was 60% in the previous year and 65% during the study (P = 0.04). Mean treatment burden scaled score on the CFQ-R was 68 at enrollment and 66 at study completion (P = 0.14). CONCLUSIONS Frequent home PFT monitoring is feasible in CF adolescents and could successfully improve medication adherence without significantly impacting treatment burden.
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Affiliation(s)
| | - Niko Kaciroti
- Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor, Michigan
| | - Lauren Kasmikha
- Pediatric Pulmonology, Michigan Medicine, Ann Arbor, Michigan
| | - Samya Z Nasr
- Pediatric Pulmonology, Michigan Medicine, Ann Arbor, Michigan
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