Identifying barriers to treatment adherence and related attitudinal patterns in adolescents with cystic fibrosis
Open accessAbstract
Introduction: The treatment of cystic fibrosis (CF) is directed toward correction of organ dysfunction and relief of symptoms resulting from the disease. Lack of adherence to daily treatment regimens may have substantial short‐term and long‐term effects on patients with CF. In this study, we attempted to identify barriers to treatment adherence which could be predicted by objective measures and explore ways to improve adherence in adolescents with CF. Methods: A questionnaire was given to patients 12.0–20.9 years of age, designed with focus on specific barriers to adhering to treatment plan and related attitudinal patterns. Observational and analytical results were collected. Results: We obtained questionnaires and objective health data for 60 respondents. The most commonly identified barriers to adherence were forgetting or losing medications (32/60) and being too busy (23/60). Attitudinal patterns that played a significant role for nonadherence included unintentional forgetting (40/60), feeling that following CF treatments resulted in less freedom in their lives (30/60), and believing it is acceptable to miss a treatment every few days (18/60) or to miss treatments when busy (18/60). Discussion: There were a few statistically significant differences of adherence patterns between demographic subgroups in our study. Males were more likely to agree that it is acceptable to miss doses if they are made up with extra doses later (24% vs. 3%, P = 0.04). Patients who perceived themselves to be less healthy agreed more to statements of limited freedom, nonsympathetic medical providers, and difficulty adhering during times of decreased symptoms. This highlights an unexpected risk: as CF progresses and patients perceive themselves to be less healthy, they may become less likely to be adherent during the periods they are feeling the best, while at the same time becoming less likely to perceive empathy from their physicians. Conclusions: Survey results describe a variety of beliefs and attitudinal patterns which contribute to nonadherence in CF treatment, especially relating to time management. While patients largely understood the importance of treatments to their health, predictors of risky behaviors could lead to targeted interventions by CF centers to address these challenges and improve adherence. Pediatr Pulmonol. 2010; 45:450–458. © 2010 Wiley‐Liss, Inc.
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Treatment beliefs (lack of perceived benefit, embarrassment, believing it is acceptable to miss treatments) have been reported to influence adherence in people with CF.
“Treatment beliefs (e.g.lack of perceived benefit, feeling embarrassed about taking treatments in public, believing it is acceptable to miss treatments) have also been reported to influence adherence to treatments in people with CF (Bregnballe 2011;Bucks 2009;Dziuban 2010;George 2010;Sawicki 2015).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Dziuban 2010
The Abstract reports that some adolescents believed it was acceptable to miss treatments, and the Discussion identifies embarrassment as a concern for younger adolescents. The paper does not specifically place that embarrassment in public; its Discussion suggests, rather than establishes, that perceived lack of benefit may contribute to missing airway-clearance therapy. (LLM, conf=0.84)
Experimental — accuracy not yet measuredPrevious studies have commonly reported reasons for non-adherence including being too busy, forgetting, and treatment burden.
“Previous studies have attempted to understand the factors influencing adherence to treatments in people with CF, and commonly reported reasons include being too busy or not having the time to take treatments, forgetting to take a treatment, and the level of treatment burden (Bregnballe 2011;Dziuban 2010;George 2010;Modi 2006a;Sawicki 2015).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Dziuban 2010
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- Authors
- Dziuban, E. J., Saab‐Abazeed, L., Chaudhry, S. R., Streetman, D. S., & Nasr, S. Z.
- Affiliations
- University of Michigan (US)
- Corresponding author
- Nasr, Samya Z.
- ORCID
- Nasr, Samya Z.
- Venue
- Pediatric Pulmonology
- Publisher
- Wiley
- Published
- 2010-04-05
- Volume
- 45
- Issue
- 5
- Pages
- 450-458
- ISSN
- 1099-0496 (ISSN-L)
- 8755-6863
- OpenAlex
- W2020684336
- Cited by
- 88
- References
- 23
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 4 · 2022: 3 · 2021: 4 · 2020: 10 · 2019: 8 · 2018: 5 · 2017: 12 · 2016: 4 · 2015: 8 · 2014: 8 · 2013: 2 · 2012: 8
- FWCI
- 4.96
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Locations
- Pediatric Pulmonology (publishedVersion)
- PubMed (publishedVersion)
- Deep Blue (University of Michigan) (submittedVersion)
- Topics
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- cystic fibrosis, medication adherence, medication non-adherence, adolescents, barriers to adherence, patient attitudes, forgetting medication, time management, health perception, sex differences
- MeSH terms
- Adolescent, Attitude to Health, Child, Cystic Fibrosis, Female, Humans, Male, Patient Compliance, Surveys and Questionnaires, Young Adult
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