Clustered randomized controlled trial of a clinic-based problem-solving intervention to improve adherence in adolescents with cystic fibrosis
Open accessAbstract
Background In Cystic Fibrosis (CF), adherence to pulmonary medications is about 50% and decreases during adolescence. Effective interventions have not been integrated into CF care. This effectiveness study tested a brief, clinic-based behavioral intervention to improve adherence.Methods iCARE (I Change Adherence and Raise Expectations) was a pragmatic, clustered, 2-arm randomized controlled trial at 18 CF Centers. 607 adolescents with CF, ages 11-20 years, participated. Centers were randomized to IMPACT (n = 9; 300 adolescents), a brief problem-solving + education intervention, or standard care (SC; n = 9; 307 adolescents). IMPACT was delivered during a regularly scheduled clinic visit by a member of the clinical care team. The primary outcome was composite pulmonary medication possession ratio (cMPR); secondary endpoints were lung function, Body Mass Index percentile, courses of IV antibiotics, and health-related quality of life at 12 months.Results Effectiveness of the intervention was tested using mixed models, generalized estimating equations comparing IMPACT to SC. Fifty-eight percent of problem-solving sessions targeted barriers to airway clearance, exercise or nutrition, while 18% addressed pulmonary medications. Average intervention fidelity score was 67% (SD = 14%; Range = 25-100%). No significant intervention effects were found for cMPR or any of the secondary outcomes compared to SC.Conclusions The IMPACT intervention did not improve medication adherence or health outcomes over 12 months. Challenges to implementing the intervention as intended during busy clinic visits were identified.Trial registry ClinicalTrials.gov; No.: NCT01232478; URL: www.clinicaltrials.gov.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Even the largest trial in this review was underpowered to find a difference in medication adherence, due to missing data and attrition.
“Even the largest trial in this review was underpowered to find a difference in medication adherence, due to missing data and attrition (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Both trials reported a cMPR measure which included a combination of inhaled therapies and one non-inhaled therapy (Quittner 2019; Shakkottai 2017).
“Both trials reported a cMPR measure which included a combination of inhaled therapies and one non-inhaled therapy (Quittner 2019;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
One trial (5 participants) assessed this outcome at the 'up to three months' time point (Shakkottai 2017), and a second trial (436 participants) reported at over six months and up to 12 months (Quittner 2019).
“One trial (5 participants) assessed this outcome at the 'up to three months' time point (Shakkottai 2017), and a second trial (436 participants) reported at over six months and up to 12 months (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
One cluster-RCT used the CF centre as the unit of randomisation to minimise cross-contamination risks from within-site randomisation.
“One cluster-RCT used the CF centre as the unit of randomisation, to minimise crosscontamination risks from within-site randomisation (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
All trials measured adherence to inhaled therapies; it was a primary outcome in four trials, a secondary outcome in three trials, and three trials did not specify between primary and secondary outcomes.
“All trials measured adherence to inhaled therapies; this was as a primary outcome in four trials (Quinn 2004;Quittner 2019;Riekert 2013;Shakkottai 2017), a secondary outcome in three trials (Hind 2017;Knudsen 2016;Wildman 2022), and three trials did not specify between primary and secondary outcomes (Cottrell 1996;Downs 2006;Gur 2016).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The results of one large, multicentre trial were difficult to interpret due to post-intervention means (and SDs) not being reported for most outcomes.
“the results of one large, multicentre trial were difficult to interpret due to post-intervention means (and SDs) not being reported for most outcomes (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Two other studies assessed treatment burden at this time point and found no difference between groups.
“2 other studies assessed treatment burden at this time point (Knudsen 2016;Quittner 2019).These 2 studies found no difference between groups.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
In the Quittner 2019 trial, challenges obtaining pharmacy records resulted in a significant amount of missing adherence data.
“In the Quittner 2019 trial, there were challenges obtaining pharmacy records, which resulted in a significant amount of missing adherence data.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The Quittner 2019 report states that intervention effects were evaluated based on the intention-to-treat principle, but it is unclear whether this included all participants entering the trial or whether some were excluded.
“The report states that intervention effects were evaluated based on the intention-to-treat principle, but it is unclear whether this included all participants entering the trial or whether some were excluded.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Of the 641 participants who consented in the Quittner 2019 trial, 308 (51%) had analysable pharmacy records at baseline and 436 (72%) had analysable pharmacy records at 12 months.
“Of the 641 participants who consented, 308 (51%) had analysable pharmacy records at baseline (n = 156 intervention; n = 152 control), and 436 (72%) had analysable pharmacy records at 12 months (n = 205 intervention; n = 231 control).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The review authors judged three trials to have a high risk of bias from other sources (Cottrell 1996; Quittner 2019; Riekert 2013).
“We judged three trials to have a high risk of bias from other sources (Cottrell 1996;Quittner 2019;Riekert 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
In the Quittner 2019 trial, participants received financial incentives for attending intervention sessions and completing assessments as acknowledgement for participation.
“In one trial, participants received financial incentives for attending intervention sessions and completing assessments as acknowledgement for participation (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The Quittner 2019 trial was a cluster-RCT in which CF centres interested in adherence-promoting strategies were invited to participate, and the first 18 CF centres to sign a contract and obtain relevant approvals were enroled, so it is likely that there could have been differences between those CF centres who volunteered to take part compared to those who did not.
“In addition, this trial was a cluster-RCT in which CF centres interested in adherence-promoting strategies were invited to participate (no other eligibility criteria for CF centres was applied).The first 18 CF centres to sign a contract and obtain relevant approvals were enroled, so it is likely that there could have been differences between those CF centres who volunteered to take part, compared”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The review authors judged two trials to have a high risk of bias as each listed an additional secondary outcome on the clinical trial register that was not reported in the published papers (Knudsen 2016; Quittner 2019).
“We judged two trials to have a high risk of bias as each listed an additional secondary outcome on the clinical trial register that was not reported in the published papers (Knudsen 2016; Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
In the Quittner 2019 trial, in the intervention group, a further 20 participants (6%) withdrew and 2 died (1%) between completing baseline and 12-month follow-up surveys, and an additional 32 (11%) did not complete the 12-month survey.
“In the intervention group, a further 20 participants (6%) withdrew and 2 died (1%) between completing baseline and 12 month follow up surveys, and an additional 32 (11%) did not complete the 12-month survey.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The Quittner 2019 report states that intervention effects were evaluated based on the intent-to-treat (ITT) principle, but it is unclear whether this included all participants entering the trial or whether some were excluded.
“Report states:”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
In the Quittner 2019 trial, in the control group, a further 13 participants (4%) withdrew and 1 died (<1%) between completing the baseline and 12-month follow-up surveys, and an additional 14 (5%) did not complete the 12-month survey.
“In the control group, a further 13 participants (4%) withdrew and 1 died (<1%) between completing the baseline and 12 month follow-up surveys, and an additional 14 (5%) did not complete the 12-month survey.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The Quittner 2019 report does not provide additional information on reasons for withdrawal or surveys not being completed.
“Report does not provide additional information on reasons for withdrawal or surveys not being completed.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Other interventions were delivered by multiple, trained healthcare professionals or researchers.
“Other interventions were delivered by multiple, trained healthcare professionals or researchers (e.g.registered nurses, physiotherapists, social workers, psychologists, research co-ordinators etc.) (Hind 2017;Quittner 2019; Wildman 2022)”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
One trial reported means and SDs for FEV1 % predicted at baseline only, so could not be included in the analysis.
“Additionally, one trial reported means and SDs for this outcome at baseline only, meaning we could not include the data from this trial in the analysis (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Two outcomes (exacerbations and lung function) were reported at baseline only in Quittner 2019; the only results interpretable were absolute post-treatment mean scores for each QoL domain, which were included in analyses as if from a parallel trial.
“Two outcomes (exacerbations and lung function) were reported at baseline only; the only results we could interpret were absolute post-treatment mean scores for each QoL domain, which we included in the analyses as if they were from a parallel trial where the unit of analysis is the participant.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The results of Quittner 2019 were quite difficult to interpret, and the review was unable to access additional data despite repeated attempts to contact the trial authors.
“The results of this study were quite difficult to interpret, and we were unable to access additional data despite repeated attempts to contact the trial authors.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Five trials stated that they had conducted fidelity assessments, usually using audio-recordings from intervention sessions.
“Five trials stated that they had conducted fidelity assessments, usually using audio-recordings from intervention sessions (Hind 2017;Quinn 2004;Quittner 2019;Riekert 2013;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Two other studies assessed respiratory symptoms at this time point and also found no difference between groups.
“2 other studies assessed respiratory symptoms at this time point (Knudsen 2016;Quittner 2019).These 2 studies also found no difference between groups.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
A single cluster-RCT was identified (Quittner 2019), and the authors reported that they used generalised estimating equations to account for clustering within sites.
“We identified a single cluster-RCT (Quittner 2019), and the authors reported that they used generalised estimating equations to account for clustering within sites.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
There was variation in the approaches used to assess fidelity, ranging from assessing intervention fidelity for the first session only to assessing a sample of sessions throughout the trial using two independent reviewers.
“There was also variation in the approaches used, ranging from assessing intervention fidelity for the first session only (Quittner 2019), to assessing a sample of sessions throughout the trial, using two independent reviewers (Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The authors of Quittner 2019 report that no significant intervention effects were found for any of the secondary outcomes compared to usual care.
“However, the authors report that no significant intervention effects were found for any of the secondary outcomes in this trial, compared to usual care (and FEV 1 % predicted was a secondary outcome in this trial) (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The authors of Quittner 2019 reported that no intervention effect was found for pulmonary exacerbations.
“The authors did however report that no intervention effect was found for pulmonary exacerbations (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Two trials included pulmonary exacerbations as a primary outcome and three trials as a secondary outcome.
“Two trials included pulmonary exacerbations as a primary outcome (Hind 2017; Wildman 2022) and three trials as a secondary outcome (Quittner 2019;Riekert 2013;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
For Quittner 2019, incomplete outcome data was high risk; of 641 families consented, 300 (93%) intervention and 307 (95%) control completed baseline survey; 589 (97%) had registry data; 308 (51%) had analysable pharmacy records at baseline; 436 (72%) at 12 months.
“Of the 641 families who consented to participate (321 in intervention group and 320 in control group), 300 (93%; Mean=33/site) in intervention and 307 (95%; Mean=34/site) in the control group completed the baseline survey ... Of those, 589 (97%) had CF Foundation Patient Registry data, 308 (51%) had analysable pharmacy records at baseline (n=156 intervention; n=152 control), 436 (72%) had analysab”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Five trials (Cottrell 1996, Knudsen 2016, Quittner 2019, Riekert 2013, Shakkottai 2017) had an unclear risk of bias from allocation concealment because they did not report on allocation concealment.
“We judged five trials to have an unclear risk of bias as they did not report on allocation concealment (Cottrell 1996;Knudsen 2016;Quittner 2019;Riekert 2013;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
For Quittner 2019, availability of a baseline cMPR score did not differ by patient characteristics.
“Availability of a baseline cMPR score did not differ by patient characteristics.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
For Quittner 2019, allocation concealment was not reported (unclear risk).
“Allocation concealment (selection bias) Unclear risk Not reported.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
For Quittner 2019, other bias was high risk because centers interested in adherence were invited, the first 18 centers signing contract and IRB approval were enrolled, no other center eligibility criteria were applied, participants were compensated, and these factors may have led to biases and affected generalizability.
“Report states: “selecting CF Centers interested in addressing adherence, randomizing CF Centers prior to participant enrollment, not collecting data on nonparticipants, and paying participants for completing PS sessions, may have led to biases and affected generalizability of the findings”.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
For Quittner 2019, 20 participants (7%) withdrew and 1 died from the intervention group between consenting and completing baseline survey; 13 participants (4%) withdrew from the control group.
“From CONSORT flow diagram (p 891 of publication), 20 participants (7%) withdrew and 1 died from the intervention group between consenting and completing baseline survey; 13 participants (4%) withdrew from the control group between consenting and completing baseline survey.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
In Quittner 2019, participants in the intervention were compensated USD 50 per session up to 4 sessions, and USD 50 for each assessment.
“In addition, participants enrolled in the intervention were compensated USD 50/session up to 4 intervention sessions.Assessment included a patient-completed survey and skills assessment; participants were compensated USD 50 for each assessment.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
The competing clinical demands of healthcare professionals can influence the extent to which an intervention can be implemented in practice, for example by limiting the amount of training and supervision that can be provided.
“As highlighted in one of the included studies in this review, the competing clinical demands of healthcare professionals can influence the extent to which an intervention can be implemented in practice (e.g.limiting the amount of training and supervision that can be provided) (Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Quittner 2019
Cites
Quanjer, P. H., Stanojevic, S., Cole, T. J., Baur, X., Hall, G. L., Culver, B. H., Enright, P., Hankinson, J., Ip, M., Zheng, J., et al. (2012) · European Respiratory Journal · doi:10.1183/09031936.00080312 · Cited by 5,944 · see citing works
High treatment burden in adults with cystic fibrosis: challenges to disease self-management
Sawicki, G. S., Sellers, D. E., & Robinson, W. M. (2009) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2008.09.007 · Cited by 498 · see citing works
Handbook of pediatric psychology
Swiezy, N. B. (1989) · Research in Developmental Disabilities · doi:10.1016/0891-4222(89)90008-5 · Cited by 481 · see citing works
Quittner, A. L., Modi, A. C., Wainwright, C., Otto, K., Kirihara, J., & Montgomery, A. B. (2009) · Chest · doi:10.1378/chest.08-1190 · Cited by 400 · see citing works
Self-citationPulmonary medication adherence and health-care use in cystic fibrosis
Quittner, A. L., Zhang, J., Marynchenko, M., Chopra, P. A., Signorovitch, J., Yushkina, Y., & Riekert, K. A. (2014) · Chest · doi:10.1378/chest.13-1926 · Cited by 250 · see citing works
Self-citationLongitudinal association between medication adherence and lung health in people with cystic fibrosis
Eakin, M. N., Bilderback, A. L., Boyle, M., Mogayzel, P. J., & Riekert, K. A. (2011) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2011.03.005 · Cited by 242 · see citing works
Self-citationAccurate Assessment of Adherence
Daniels, T., Goodacre, L., Sutton, C., Pollard, K., Conway, S., & Peckham, D. (2011) · Chest · doi:10.1378/chest.09-3074 · Cited by 210 · see citing works
Quittner, A. L. (2000) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/25.6.403 · Cited by 158 · see citing works
Self-citationDeLambo, K. E., Ievers‐Landis, C. E., Drotar, D., & Quittner, A. L. (2004) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsh038 · Cited by 146 · see citing works
Self-citationPsychometric evaluation of the Cystic Fibrosis Questionnaire-Revised in a national sample
Quittner, A. L., Sawicki, G. S., McMullen, A. H., Rasouliyan, L., Pasta, D. J., Yegin, A., & Konstan, M. W. (2011) · Quality of Life Research · doi:10.1007/s11136-011-0036-z · Cited by 139 · see citing works
Self-citationHill‐Briggs, F., Lazo, M., Peyrot, M. F., Doswell, A., Chang, Y., Hill, M. N., Levine, D. M., Wang, N. Y., & Brancati, F. L. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1689-6 · Cited by 125 · see citing works
Modi, A. C., Marciel, K. K., Slater, S. K., Drotar, D., & Quittner, A. L. (2008) · Children s Health Care · doi:10.1080/02739610701766925 · Cited by 125 · see citing works
Self-citationFitzpatrick, S. L., Schumann, K. P., & Hill‐Briggs, F. (2013) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2012.12.016 · Cited by 123 · see citing works
Nansel, T. R., Iannotti, R. J., & Liu, A. (2012) · PEDIATRICS · doi:10.1542/peds.2011-2858 · Cited by 97 · see citing works
Managed Problem Solving for Antiretroviral Therapy Adherence: A Randomized Trial
Gross, R., Bellamy, S. L., Chapman, J., Han, X.-Y., O’Duor, J., Palmer, S., Houts, P., Coyne, J., & Strom, B. (2013) · JAMA Internal Medicine · doi:10.1001/jamainternmed.2013.2152 · Cited by 88 · see citing works
Parental Depression and Pancreatic Enzymes Adherence in Children With Cystic Fibrosis
Barker, D., & Quittner, A. L. (2016) · PEDIATRICS · doi:10.1542/peds.2015-2296 · Cited by 75 · see citing works
Self-citationModi, A. C., Guilfoyle, S. M., Mann, K. A., & Rausch, J. R. (2015) · Epilepsia · doi:10.1111/epi.13289 · Cited by 64 · see citing works
Nansel, T. R., Iannotti, R. J., Simons‐Morton, B. G., Plotnick, L., Clark, L. M., & Zeitzoff, L. (2009) · Diabetes Care · doi:10.2337/dc08-1968 · Cited by 57 · see citing works
Oates, G. R., Štěpáníková, I., Gamble, S., Gutierrez, H. H., & Harris, W. T. (2015) · Pediatric Pulmonology · doi:10.1002/ppul.23317 · Cited by 50 · see citing works
Carson, S. S., Goss, C. H., Patel, S. R., Anzueto, A., Au, D. H., Elborn, J. S., Gerald, J. K., Gerald, L. B., Kahn, J. M., Malhotra, A., et al. (2013) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201310-1790st · Cited by 49 · see citing works
Self-citationFitzpatrick, S. L., Golden, S. H., Stewart, K., Sutherland, J., DeGross, S., Brown, T., Wang, N.-Y., Allen, J., Cooper, L. A., & Hill-Briggs, F. (2016) · Diabetes Care · doi:10.2337/dc16-0941 · Cited by 49 · see citing works
Stanojevic, S., Stocks, J., Bountziouka, V. P., Aurora, P., Kirkby, J. C., Bourke, S., Carr, S. B., Gunn, E., Prasad, A., Rosenfeld, M., et al. (2013) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2013.11.006 · Cited by 47 · see citing works
Stark, L. J., Opipari‐Arrigan, L., Quittner, A. L., Bean, J. A., & Powers, S. W. (2010) · Pediatric Pulmonology · doi:10.1002/ppul.21322 · Cited by 46 · see citing works
Self-citationOpportunities for cystic fibrosis care teams to support treatment adherence
Riekert, K. A., Eakin, M. N., Bilderback, A. L., Ridge, A. K., & Marshall, B. C. (2014) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2014.10.003 · Cited by 45 · see citing works
Self-citationAdherence to dornase alfa treatment among commercially insured patients with cystic fibrosis
Nasr, S. Z., Chou, W., Villa, K. F., Chang, E., & Broder, M. S. (2013) · Journal of Medical Economics · doi:10.3111/13696998.2013.787427 · Cited by 44 · see citing works
Stark, L. J., Opipari‐Arrigan, L., Filigno, S. S., Simon, S. L., Leonard, A., Mogayzel, P. J., Rausch, J. R., Zion, C., & Powers, S. W. (2015) · Journal of Pediatric Psychology · doi:10.1093/jpepsy/jsv108 · Cited by 17 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Voytek, T. M., Ro, J. Y., Edeiken, J., & Ayala, A. G. (1995) · The American Journal of Surgical Pathology · doi:10.1097/00000478-199507000-00005 · Cited by 107 · see citing works
68Ga-FAPI PET visualize heart failure: from mechanism to clinic
Song, W., Zhang, X., He, S., Gai, Y., Qin, C., Hu, F., Wang, Y., Wang, Z., Bai, P., Wang, J., et al. (2022) · European Journal of Nuclear Medicine and Molecular Imaging · doi:10.1007/s00259-022-05994-4 · Cited by 55 · see citing works
Wildman, M. J., O’Cathain, A., Maguire, C., Arden, M. A., Hutchings, M., Bradley, J., Walters, S. J., Whelan, P., Ainsworth, J., Buchan, I., et al. (2022) · Thorax · doi:10.1136/thoraxjnl-2021-217594 · Cited by 54 · see citing works
Arden, M. A., Hutchings, M., Whelan, P., Drabble, S. J., Beever, D., Bradley, J. M., Hind, D., Ainsworth, J., Maguire, C., Cantrill, H., et al. (2021) · Pilot and Feasibility Studies · doi:10.1186/s40814-020-00739-2 · Cited by 44 · see citing works
Overweight and cystic fibrosis: An unexpected challenge
Gabel, M. E., Fox, C. K., Grimes, R. A., Lowman, J. D., McDonald, C. M., Stallings, V. A., & Michel, S. H. (2021) · Pediatric Pulmonology · doi:10.1002/ppul.25748 · Cited by 28 · see citing works
Randomized and non-randomized designs for causal inference with longitudinal data in rare disorders
Izem, R., & McCarter, R. (2021) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-021-02124-5 · Cited by 25 · see citing works
Dawson, S., Girling, C.-J., Cowap, L., & Clark-Carter, D. (2023) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013766.pub2 · Cited by 14 · see citing works
Wildman, M. J., O’Cathain, A., Hind, D., Maguire, C., Arden, M. A., Hutchings, M., Bradley, J. M., Walters, S. J., Whelan, P., Ainsworth, J. D., et al. (2021) · Programme Grants for Applied Research · doi:10.3310/pgfar09110 · Cited by 11 · see citing works
Multi-dimensional clinical phenotyping of a national cohort of adult cystic fibrosis patients
Conrad, D. J., Billings, J. L., Tenebäck, C. C., Koff, J. L., Rosenbluth, D., Bailey, B., & Jain, R. (2020) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2020.08.010 · Cited by 11 · see citing works
Adherence to medicine in adolescence
Pearce, C. J., Azam, A., Barry, P. J., & d’Ancona, G. (2024) · European Respiratory Society eBooks · doi:10.1183/2312508x.10011223 · Cited by 7 · see citing works
Sandler, R. D., & Wildman, M. J. (2022) · Healthcare · doi:10.3390/healthcare11010020 · Cited by 7 · see citing works
Riekert, K. A., Ford, C., Goodman, A. S., Eckmann, T., Green, A., & Quittner, A. L. (2024) · Journal of Cystic Fibrosis · doi:10.1016/j.jcf.2024.10.011 · Cited by 5 · see citing works
Self-citationViprey, M., Mougeot, F., Dima, A. L., Haesebaert, J., Occelli, P., Durieu, I., Rouzé, H., Reynaud, Q., & Touzet, S. (2023) · Patient Preference and Adherence · doi:10.2147/ppa.s389792 · Cited by 4 · see citing works
Driscoll, K. A., & Modi, A. C. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816000-8.00001-3 · Cited by 4 · see citing works
Richards, B., Osborne, S. R., & Simons, M. (2022) · BMC Health Services Research · doi:10.1186/s12913-021-07373-5 · Cited by 3 · see citing works
DÖNMEZ, H., & Arslan, F. T. (2024) · Comprehensive Child and Adolescent Nursing · doi:10.1080/24694193.2024.2411986 · Cited by 3 · see citing works
Quittner, A. L., & Li-Rosi, A. M. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-816000-8.00005-0 · Cited by 2 · see citing works
Self-citationUnderstanding Treatment Adherence in Cystic Fibrosis: Challenges and Opportunities
Muther, E., Butcher, J. L., & Riekert, K. A. (2020) · Respiratory medicine · doi:10.1007/978-3-030-42382-7_22 · Cited by 2 · see citing works
Self-citationCan clinical benefits of modulators effectively ‘modulate’ adherence in people with CF?
Davis, C. S., & Cogen, J. D. (2021) · Thorax · doi:10.1136/thoraxjnl-2021-216974 · Cited by 2 · see citing works
Cystic fibrosis year in review 2019: Section 3 multisystem‐based care and research
Savant, A. P., & McColley, S. A. (2020) · Pediatric Pulmonology · doi:10.1002/ppul.25158 · Cited by 1 · see citing works
Butcher, J. L. (2021) · Respiratory medicine · doi:10.1007/978-3-030-68688-8_4 · Cited by 1 · see citing works
Arden, M. A., Hutchings, M., Whelan, P., Drabble, S. J., Beever, D., Bradley, J. M., Hind, D., Ainsworth, J. D., Maguire, C., Cantrill, H., et al. (2020) · doi:10.31234/osf.io/gbcpk
Richards, B., Osborne, S. R., & Simons, M. (2022) · Figshare · doi:10.6084/m9.figshare.19068792
Richards, B., Osborne, S. R., & Simons, M. (2022) · Figshare · doi:10.6084/m9.figshare.19068801
Richards, B., Osborne, S. R., & Simons, M. (2022) · Figshare · doi:10.6084/m9.figshare.19068798
Richards, B., Osborne, S. R., & Simons, M. (2022) · Figshare · doi:10.6084/m9.figshare.19068804
Advances in Health‐Related Quality of Life in Primary Ciliary Dyskinesia
Quittner, A. L., Davalillo, I. P., Cragun, D. M., & Saunders, J. L. (2026) · Pediatric Pulmonology · doi:10.1002/ppul.71785
Self-citation
- Authors
- Quittner, A. L., Eakin, M. N., Alpern, A. N., Ridge, A. K., McLean, K. A., Bilderback, A., Criado, K. K., Chung, S.-E., & Riekert, K. A.
- Affiliations
- Miami Children's Hospital (US)
- Johns Hopkins University (US)
- University of Miami (US)
- Corresponding author
- Quittner, Alexandra L.
- Venue
- Journal of Cystic Fibrosis
- Publisher
- Elsevier BV
- Published
- 2019-11
- Volume
- 18
- Issue
- 6
- Pages
- 879-885
- ISSN
- 1569-1993 (ISSN-L)
- OpenAlex
- W2945014152
- Cited by
- 27
- References
- 26
- Citations by year
- 2026: 1 · 2024: 3 · 2023: 2 · 2022: 7 · 2021: 7 · 2020: 6
- FWCI
- 5.14
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of Cystic Fibrosis (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Genentech
- Cystic Fibrosis Foundation
- 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
- medication adherence, adolescents, problem-solving intervention, medication possession ratio, lung function, health-related quality of life, intervention fidelity, implementation barriers
- MeSH terms
- Internet-Based Intervention, Adolescent, Adolescent Behavior, Ambulatory Care, Cystic Fibrosis, Female, Humans, Health Knowledge, Attitudes, Practice, Male, Problem Solving, Quality of Life, Outcome Assessment, Health Care, Telemedicine, Respiratory System Agents, Behavior Control, Medication Adherence
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
