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08-09-2017 | Uitgave 1/2018

Quality of Life Research 1/2018

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

Tijdschrift:
Quality of Life Research > Uitgave 1/2018
Auteurs:
James W. Varni, Robert J. Shulman, Mariella M. Self, Shehzad A. Saeed, George M. Zacur, Ashish S. Patel, Samuel Nurko, Deborah A. Neigut, James P. Franciosi, Miguel Saps, Jolanda M. Denham, Chelsea Vaughan Dark, Cristiane B. Bendo, John F. Pohl, On Behalf of the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module Testing Study Consortium
Belangrijke opmerkingen
Investigators for the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module Testing Study Consortium are listed in “Acknowledgements”.
The PedsQL™ is available at http://​www.​pedsql.​org.

Abstract

Objectives

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.

Methods

The Pediatric Quality of Life Inventory™ 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.

Results

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.

Conclusions

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.

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