儿童和青少年ADHD患者的药物依从性。

IF 0.8 4区 医学 Q4 PSYCHIATRY
Konstantin Mechler, Tobias Banaschewski, Tobias Hellenschmidt, Christoph U Correll, Frank M Theisen, Michael Kaess, Michael Kölch, Gerhard Libal, Tobias J Renner, Jörg M Fegert, Andreas Karwautz, Paul L Plener, Peter Heuschmann, Stefanie Fekete, Marcel Romanos, Karin Egberts, Alexander Häge
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引用次数: 0

摘要

目的:注意缺陷/多动障碍(ADHD)影响全世界6- 10%的儿童和青少年。虽然精神药理学治疗有效地减轻了症状,但不完全坚持是常见的,降低了其有效性。本研究调查了儿童和青少年ADHD患者的药物依从性及其预测因素。方法:TDM-VIGIL研究是德国的一项多中心前瞻性观察性研究,研究了ADHD药物在多动障碍和不依从性中的相关风险。年龄6-18岁的ADHD (ICD-10/DSM-IV)患者使用药物评估问卷(MAQ)在多个时间点评估兴奋剂或非兴奋剂的不依从性。将患者分为完全依从或不完全依从,并使用逻辑回归分析来确定预测因素。结果:在198名参与者(平均年龄= 10.4岁)中,66.1% - 75.4%的人在各个时间点上完全坚持。较高的年龄和较低的智力与不依从性显著相关,而性别、疾病严重程度、不良事件、治疗环境(门诊、日间诊所、住院)、药物类别(兴奋剂、非兴奋剂)和治疗策略(单药还是多药)与不依从性无关。结论:药物不依从在青少年ADHD患者中很常见,年龄越大、智力越低是相关的危险因素。临床医生应持续监测依从性并解决个体障碍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medication Nonadherence in Children and Adolescents with ADHD.

Objective: Attention-deficit/hyperactivity disorder (ADHD) affects 6-10 % of children and adolescents worldwide. While psychopharmacological treatments effectively reduce symptoms, incomplete adherence is common, diminishing their effectiveness. This study investigated medication nonadherence and its predictors in children and adolescents with ADHD. Method: The TDM-VIGIL study, a multicenter prospective observational study in Germany, examined drug-related risks of ADHD medication in hyperkinetic disorders and nonadherence. Participants aged 6-18 years with ADHD (ICD-10/DSM-IV) starting stimulants or nonstimulants were assessed for nonadherence using the Medication Assessment Questionnaire (MAQ) at multiple time points. Patients were classified as fully or not fully adherent, and logistic regression analysis was used to identify predictors. Results: Among 198 participants (mean age = 10.4 years), 66.1 %-75.4 % were fully adherent across time points. Higher age and lower intelligence were significantly associated with nonadherence, while sex, disease severity, adverse events, treatment setting (outpatient, day clinic, inpatient), medication class (stimulant, nonstimulant), and treatment strategy (mono- versus polypharmacy) were not. Conclusions: Medication nonadherence is common in youth with ADHD, with higher age and lower intelligence representing relevant risk factors. Clinicians should consistently monitor adherence and address individual barriers.

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来源期刊
CiteScore
1.90
自引率
16.70%
发文量
74
期刊介绍: Die Zeitschrift veröffentlicht Originalarbeiten, Übersichtsreferate, Fallberichte, aktuelle Mitteilungen und Buchbesprechungen und informiert laufend über die Arbeit anderer internationaler Fachzeitschriften. Sie ist offizielles Organ der Deutschen Gesellschaft für Kinder- und Jugendpsychiatrie, Psychosomatik und Psychotherapie.
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