Objective Versus Self-Reported Adherence to Airway Clearance Therapy in Cystic Fibrosis.


Journal

Respiratory care
ISSN: 1943-3654
Titre abrégé: Respir Care
Pays: United States
ID NLM: 7510357

Informations de publication

Date de publication:
Feb 2019
Historique:
pubmed: 13 12 2018
medline: 5 3 2020
entrez: 13 12 2018
Statut: ppublish

Résumé

Historically, studies of adherence to airway clearance therapy in cystic fibrosis (CF) have relied on self-reporting. We compared self-reported airway clearance therapy adherence to actual usage data from home high-frequency chest wall compressions (HFCWC) vests and identified factors associated with overestimation of adherence in self-reports. Pediatric patients who perform airway clearance therapy with a HFCWC vest were eligible to participate. Objective adherence data were obtained from the HFCWC device, which records cumulative utilization time. Two readings at least 5 weeks apart were collected. Objective adherence was recorded as a ratio of mean-to-prescribed daily use (%). Self-reported adherence data were collected with a caregiver survey at enrollment. Adherence rates were categorized as low (< 35% of prescribed), moderate (36-79% of prescribed), and high (≥ 80% of prescribed). An overestimation was present when self-reported adherence was at least one category higher than objective adherence. In the final sample ( Self-reports overestimated actual adherence to airway clearance therapy, and the overestimation increased with treatment occurring in multiple households and prescribed therapy duration. Among participants with prescribed airway clearance therapy ≥ 60 min, overestimation increased with lower income. Objective measures of adherence are needed, particularly for lower-income children and those receiving treatments in multiple locations.

Sections du résumé

BACKGROUND BACKGROUND
Historically, studies of adherence to airway clearance therapy in cystic fibrosis (CF) have relied on self-reporting. We compared self-reported airway clearance therapy adherence to actual usage data from home high-frequency chest wall compressions (HFCWC) vests and identified factors associated with overestimation of adherence in self-reports.
METHODS METHODS
Pediatric patients who perform airway clearance therapy with a HFCWC vest were eligible to participate. Objective adherence data were obtained from the HFCWC device, which records cumulative utilization time. Two readings at least 5 weeks apart were collected. Objective adherence was recorded as a ratio of mean-to-prescribed daily use (%). Self-reported adherence data were collected with a caregiver survey at enrollment. Adherence rates were categorized as low (< 35% of prescribed), moderate (36-79% of prescribed), and high (≥ 80% of prescribed). An overestimation was present when self-reported adherence was at least one category higher than objective adherence.
RESULTS RESULTS
In the final sample (
CONCLUSIONS CONCLUSIONS
Self-reports overestimated actual adherence to airway clearance therapy, and the overestimation increased with treatment occurring in multiple households and prescribed therapy duration. Among participants with prescribed airway clearance therapy ≥ 60 min, overestimation increased with lower income. Objective measures of adherence are needed, particularly for lower-income children and those receiving treatments in multiple locations.

Identifiants

pubmed: 30538158
pii: respcare.06436
doi: 10.4187/respcare.06436
pmc: PMC6818680
doi:

Types de publication

Comparative Study Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

176-181

Subventions

Organisme : NIDDK NIH HHS
ID : P30 DK072482
Pays : United States

Informations de copyright

Copyright © 2019 by Daedalus Enterprises.

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Auteurs

Gabriela R Oates (GR)

Division of Pediatric Pulmonary and Sleep Medicine, as well as the Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Alabama. goates@uab.edu.

Irena Stepanikova (I)

Department of Sociology, University of Alabama at Birmingham and Research Center for Toxic Compounds in the Environment (RECETOX), Masaryk University, Czech Republic.

Steven M Rowe (SM)

Division of Pediatric Pulmonary and Sleep Medicine, as well as the Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Alabama.
Departments of Medicine and Cell Developmental and Integrative Biology, University of Alabama at Birmingham.

Stephanie Gamble (S)

Children's Hospital of Alabama, Birmingham, Alabama.

Hector H Gutierrez (HH)

Division of Pediatric Pulmonary and Sleep Medicine, as well as the Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Alabama.

William T Harris (WT)

Division of Pediatric Pulmonary and Sleep Medicine, as well as the Gregory Fleming James Cystic Fibrosis Research Center, University of Alabama at Birmingham, Alabama.

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Classifications MeSH