Adherence to nebulised therapies in adolescents with cystic fibrosis is best on week-days during school term-time
Open accessAbstract
Objectives Treatment regimen for families of children with cystic fibrosis (CF) is considerable, particularly when nebulised therapies for chronic Pseudomonas aeruginosa airway infection are prescribed. Adherence to these regimens is variable, particularly in adolescence. Previously, we reported children to be more adherent in evenings compared to mornings, suggesting an association with time-pressure. The aim of this study was to determine whether adherence would be better in adolescent patients at weekends and during school holidays when time-pressures may be less.Study design 24 patients (14 male, median [range] age 13.9 [11.1-16.8] years) were enrolled from two regional paediatric CF centres in the United Kingdom. Data for a full scholastic year, were downloaded openly from a breath-activated data logging nebuliser (I-neb™). Adherence (% of doses taken÷expected number) was calculated during term-times, holidays, weekends and weekdays, for each patient.Results Large variations in adherence were seen between patients. However, adherence during term-time was significantly better than holidays (p<0.001). Weekday adherence was better than weekend adherence in term-time but not holidays. Interestingly, patients prescribed three daily treatments took on average 1.4 treatments/day, a similar number to those prescribed two daily treatments.Conclusion Overall adherence to inhaled therapies was reasonable, but significantly reduced during holiday periods. This suggests a need for families to have not only time, but also structure in their daily routine to maintain optimal adherence to long-term therapies. It is important for CF teams to appreciate these factors when supporting families.
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Trials using objective recorded measures suggest that adherence to inhaled therapies in people with CF is around 65% to 67% in children or adolescents.
“and 65% to 67% in children or adolescents (Ball 2013;McNamara 2009).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Ball 2013
Objective adherence data collected using date-and time-logging nebulisers have demonstrated that, amongst adolescents with CF, adherence to inhaled therapies is greater on school days compared to weekends or holidays.
“Objective adherence data, collected using date-and time-logging nebulisers, have demonstrated that, amongst adolescents with CF, adherence to inhaled therapies is greater on school days compared to weekends or holidays (Ball 2013), despite this being a time when adolescents are likely to be busiest and are therefore more susceptible to miss treatments due to burden (Hoo 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Ball 2013
The results may be consistent with previous research highlighting the role of habit on adherence to inhaled therapies in people with cystic fibrosis, and with the suggestion that habit may attenuate the relationship between treatment complexity and perceived treatment burden.
“This may be consistent with previous research highlighting the role of habit on adherence to inhaled therapies in people with CF (Arden 2019;Ball 2013;Hoo 2017;Hoo 2019a), and the suggestion that habit (i.e.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Ball 2013
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- Authors
- Ball, R., Southern, K. W., McCormack, P., Duff, A. J. A., Brownlee, K. G., & McNamara, P. S.
- Affiliations
- Leeds General Infirmary (GB)
- University of Liverpool (GB)
- Corresponding author
- McNamara, Paul S.
- Venue
- Journal of Cystic Fibrosis
- Publisher
- Elsevier BV
- Published
- 2013-09
- Volume
- 12
- Issue
- 5
- Pages
- 440-444
- ISSN
- 1569-1993 (ISSN-L)
- OpenAlex
- W2168257476
- Cited by
- 53
- References
- 12
- Citations by year
- 2026: 1 · 2024: 1 · 2023: 2 · 2022: 3 · 2021: 3 · 2020: 7 · 2019: 7 · 2018: 3 · 2017: 6 · 2016: 4 · 2015: 6 · 2014: 7 · 2013: 2
- FWCI
- 5.15
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cystic Fibrosis (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Medicine › Family Practice › Medication Adherence and Compliance
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Inhalation and Respiratory Drug Delivery
- Keywords
- medication adherence, adolescents, Pseudomonas aeruginosa, school holidays, weekends, time pressure, daily routine, inhalation therapy
- MeSH terms
- Assessment of Medication Adherence, Adolescent, Child, Cystic Fibrosis, Female, Humans, Male, Nebulizers and Vaporizers, Respiratory Therapy, Retrospective Studies, Schools, Drug Monitoring, Medication Adherence
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