小儿特应性皮炎的治疗依从性:系统回顾

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Caitlyn B Dagenet, Lauren Gawey, Sahar Davoudi, Elaine Ma, Charlotte Jeong, Swetha Atluri, Jay M Kincannon, Jennifer L Hsiao, Steven R Feldman, Vivian Y Shi
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引用次数: 0

摘要

简介:小儿特应性皮炎(AD)治疗方案的依从性非常复杂,是优化治疗效果的一大挑战。我们旨在回顾与小儿特应性皮炎不依从性相关的因素,并提出改善依从性的干预措施:系统检索了 PubMed 和 EMBASE 数据库中 2000 年至 2023 年 2 月与 AD 和依从性相关的文章,并于 2023 年 12 月进行了更新。排除了非人类研究、综述、评论和荟萃分析。根据篇幅将文章分为儿童研究人群和成人研究人群。在此,我们对讨论儿科患者依从性因素的论文进行了研究:共有 62 项研究符合纳入标准。36项研究对患者和护理人员(N = 10,268)进行了调查,以确定坚持治疗的障碍。纳入的研究中没有一项专门针对系统性药物。障碍包括护理者生活质量差、AD 相关教育不足、局部皮质类固醇(TCS)恐惧症、治疗相关指导不明确以及对医生互动不满意。五项研究仅使用药物电子监测系统、Morisky 药物依从性量表或自我报告依从性来衡量局部用药的依从性。21 项研究介绍了由护士主导或基于网络的教育计划、短信或电子邮件提醒以及局部用药教育等干预措施。护理人员教育计划、每日短信提醒、湿疹行动计划、TCS药效 "红绿灯 "颜色系统以及频繁的随访可提高依从性:结论:坚持儿科AD治疗对护理人员和患者来说是一个多因素的挑战。这项研究提供了优化坚持治疗策略的指标,因为坚持治疗对于预防儿童 AD 相关长期后遗症至关重要。随着AD治疗范围的迅速扩大,进一步的研究对评估儿科对新的局部、口服和注射药物的依从性至关重要:试验注册:PROCROPERO:CRD42023488557。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Treatment Adherence in Pediatric Atopic Dermatitis: A Systematic Review.

Introduction: Adherence to pediatric atopic dermatitis (AD) treatment regimens can be complex and a major challenge to optimizing treatment outcome. We aimed to review factors associated with nonadherence in pediatric AD and propose interventions to improve adherence.

Methods: PubMed and EMBASE databases were systematically searched for articles from 2000 to February 2023 related to AD and adherence, with an additional update in December 2023. Non-human studies, reviews, commentaries, and meta-analyses were excluded. Articles were sorted into pediatric versus adult study population based on volume. Herein, we examine the results of papers discussing adherence factors related to pediatric patients.

Results: A total of 62 studies met inclusion criteria. Thirty-six studies surveyed patients and caregivers (N = 10,268) to identify barriers to treatment adherence. None of the included studies were specific to systemic medications. Barriers included poor caregiver quality of life, inadequate AD-related education, topical corticosteroid (TCS) phobia, unclear therapy-related instructions, and dissatisfaction with physician interaction. Five studies solely measured adherence using medication electronic monitoring systems, Morisky medication adherence scale, or self-reported adherence to measure adherence to topical medications. Twenty-one studies described interventions involving nurse-led or web-based education programs, text message or email reminders, and TCS education. Adherence was improved with caregiver education programs, daily text-message reminders, eczema action plans, TCS potency "traffic light" color system, and frequent follow-up visits.

Conclusion: Adherence to pediatric AD treatment poses a multifactorial challenge for caregivers and patients. This study provides an index of strategies to optimize adherence, as it is essential for prevention of long-term sequela associated with AD in children. As the AD treatment landscape rapidly expands, further studies are vital to assess pediatric adherence to new topical, oral, and injectable medications.

Trial registration: PROSPERO: CRD42023488557.

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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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