注意缺陷多动障碍儿童用药依从性的影响因素研究
- 王瑜,张凤玲,陈佳英
作者信息
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Study on factors affecting medication compliance in children with attention deficit hyperactivity disorder
- WANG Yu, ZHANG Feng-ling, CHEN Jia-ying
Author information
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文章历史
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摘要
【目的】 研究注意缺陷多动障碍(attention-deficit/hyperactivity disorder,ADHD)儿童用药依从性的影响因素,以采取相应措施,进一步提高治疗依从性,改善ADHD儿童预后。 【方法】 2009年9月-2010年2月期间于上海市儿童医院儿保所门诊就诊的儿童,根据美国精神障碍诊断和统计手册第4版(DSM-IV)初次诊断为ADHD、排除共病、就诊前未接受治疗,就诊后使用中枢兴奋剂治疗者,首次用药6个月后由家长填写自行编制的ADHD儿童用药依从性家长问卷,共随访642例,其中男514例,女128例。用χ2检验以初步筛选影响用药依从性的因素,进一步用Logistic回归分析影响用药依从性的主要因素。 【结果】 用药依从性好者占39.8%,影响用药依从性的主要因素依次为是否参加父母培训(OR=0.076,P<0.01)、担心药物副反应(OR=0.126,P<0.01)、人均月收入(OR=0.149,P<0.05)、服药次数(OR=0.201,P<0.05)、医疗费用支付方式(OR=0.262,P<0.05)和疾病分型(OR=4.000,P<0.05)。 【结论】 提高父母对ADHD认知水平,探讨ADHD社区服务的模式,有助于提高ADHD药物治疗的依从性。
Abstract
【Objective】 To investigate the factors affecting medication compliance in children with attention deficit/hyperactivity disorder(ADHD). 【Method】 From September 2009 to February 2010,a total of 642 children with ADHD were selected, and factors affecting medication compliance were assessed with a self-administered questionnaire. 【Results】 Good compliance in medication compliance was 39.8%. The factors affecting medication complience were significant following as: parent training(OR=0.076,P<0.01), concerning about drug side effect(OR=0.126,P<0.01), family incomings(OR=0.149,P<0.05), frequency of dosing(OR=0.201,P<0.05), ways of paying medieal treatment(OR=0.262,P<0.05) and the type of the diseases(OR=4.000,P<0.05). 【Conclusion】 The results indicate both the training to improve parents' knowledge about ADHD and the investigation on the model of community service about ADHD will elevate the rate of children received medication.
关键词
Key words
attention-deficit /hyperactivity disorder / medication / compliance
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参考文献
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[2] Hu YZ. Subtyping and inquiring for etiology of children ADHD aged 6 to 12 years[J]. Chin J School Doctor, 1998, 12: 321-324.
[3] Todd RD, Huang H, Henderson CA. Poor utility of the age of onset criterion for DSM-IV attention deficit/hyperactivity disorder: recommendations for DSM-V and ICD-11[J]. Child Psychol Psychiatry, 2008,49(9):942-949.
[4] Goodman DW.The consequences of attention-deficit/hyperactivity disorder in adults[J]. J Psychiatr Pract, 2007,13(5):318-327.
[5] 金星明.注意缺陷多动障碍的药物治疗[J].中国实用儿科杂志, 2005,20(6):526-528.
[6] 钱秋瑾,王玉凤,杜亚松,等.盐酸哌甲酯控释片治疗注意缺陷多动障碍的多中心、随机、双盲、交叉对照研究[J].中华精神科杂志,2005,38(2):90-94.
[7] AAP.Clinical practice guideline: treatment of the school-aged child with attention-deficit/hyperactivity disorde[J].Pediatrics,2001,108(4):1033-1044.
[8] Brown RT, Amler RW, Freeman WS, et al.Treatment ofaattention-deficit/hyperactivity disorder: overview of the evidence[J]. Pediatrics,2005,115(6):749-757.
[9] Pritchard D.Attention deficit hyperactivity disorder in children[J]. Clin Evid,2006,15:331-344.
[10] Silva RR.Methylphenidate transdermal system in attention-deficit hyperactivity disorder in children[J].Drugs, 2006,66(8):1127-1128.
[11] Faraone SV, Spencer T, Aleardi M, et al. Meta-analysisof the efficacy of methylphenidate for treating adult attention-deficit/hyperactivity disorder[J]. J Clin Psychopharmaco, 2004, 24: 24-29.
[12] Dopheide JA, Pliszka SR. Attention-deficit-hyperactivity disorder: an update[J]. Pharmacotherapy, 2009,29(6):656-679.
[13] Kuntisi J, Mcloughlin G, Asherson P. Attention deficit hyperactivity disorder[J]. Neuro Molecular Medicine, 2006, 8: 461-484.
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