Study Of Medication Adherence And Influencing Factors In Children With Chronic Diseases

Objectives:The purpose of this study was to identify the medication knowledge,belief and adherence behavior in children with chronic diseases,to understand the medication knowledge,belief and medication support behavior of their parents,to explore the relationship between medication knowledge,belief and adherence behaviors in children with chronic diseases,and to analyze the influencing factors of medication adherence behavior in children with chronic diseases,in order to provide scientific basis for improving the medication adherence of children with chronic diseases.Methods:A cross-sectional design was used for this study.Convenient sampling was applied to select the pediatric outpatient clinics of a tertiary hospital in Shanxi Province from June 2018 to October 2018,and 220 children with chronic diseases and their parents who met the inclusion and exclusion criteria were recruited as Participants.The instruments for data collection consist of general information questionnaire,children's medication knowledge,belief and adherence behavior questionnaire,parents'medication knowledge,belief and medication support behavior questionnaire.All data was input into EpiData version 3.1 and entered in SPSS statistical software,version 19.0.Data analysis was described by frequency,percentage,mean,standard deviation,median and inter-quartiles range,and further analyzed by independent t-test,analysis of variance,Kruskal-Wallis test,Pearson correlation analysis,Spearman correlation analysis and multiple linear stepwise regressions.Results:1.220 children's mean age was 12.10±1.928 years.Boys and girls were 124(56.4%)and 96(43.6%)separately.One-thirds of the children were only children(69,31.4%)and67(30.5%)children were absent from school.144(65.5%)children had a disease duration of 6 to 36 months,and 126(57.3%)children needed to take 3 to 6 drugs each time.220 parents'mean age was 40.75±6.90years.Male and female parents were63(28.6%)and 157(71.4%)separately.Mothers made up 67.3%of the parents Sample.About half of the parents were educated in junior high school(109,49.5%).38(17.3%)parents were educated at the university level or above.2.The score for children's medication knowledge was 21.04±5.539.The children's medication knowledge at low,moderate and high levels accounted for 18.2%,43.6%and38.2%separately.The children's medication belief score ranged from-5 to 18,with a median of 4.The children's medication belief at low,moderate and high levels accounted for 8.6%,10.5%and 80.9%separately.The score for children's medication adherence was 14.09±1.858.66.8%of the children had poor medication adherence.The scores of each dimensionality,from the highest to the lowest,were as follows:long-term adherence(3.72±0.614),proper dosage(3.62±0.572),correct frequency(3.42±0.595),and being on time(3.30±0.657).3.The score for parents'medication knowledge was 21.45±5.336.The parents'medication knowledge at low,moderate and high levels accounted for 14.1%,42.3%and43.6%separately.The parents'medication belief score ranged from-8 to 12,with a median of 2.The parents'medication belief at low,moderate and high levels accounted for 25.0%,9.1%and 65.9%separately.The parents'medication support score ranged from 14 to 24,with a median of 22.Parents whose medication support great and bad were 115(52.3%)and 105(47.7%)separately.4.The children's medication knowledge was significantly related to medication adherence(r=0.162,P=0.017).There was no significantly correlation between medication knowledge and medication belief in children with chronic disease(r_s=0.083,P=0.220),and between medication belief and medication adherence(r_s=0.062,P=0.360).5.In the univariate analysis,whether children initiatived to take the medicine(F=12.814,P<0.001),children's medication knowledge(H=7.455,P=0.024),course of disease(F=5.114,P=0.007),whether children were hospitalized(t=-2.438,P=0.016),number of hospitalizations(H=11.458,P=0.009),the types of medication to be taken at one day(F=4.265,P=0.015),the types of medication to be taken at one time(F=5.009,P=0.007),parents'medication belief(F=3.244,P=0.041),and medication support(t=-5.716,P<0.001)influenced the score of medication adherence.6.In the multiple linear stepwise regressions,medication support(?=0.281),whether children initiatived to take the medicine(?=0.222),number of hospitalizations(?=0.145)and parents'medication belief(?=0.131)entered the regression model of medication adherence,with an adjusted R~2 of 0.206.Conclusions:1.The medication adherence of children with chronic diseases is not optimistic.2.The medication knowledge is correlated with medication adherence among children with chronic illness.3.The influencing factors of medication adherence of children with chronic diseases are medication support,whether children initiatived to take the medicine,number of hospitalizations and parents'medication belief.