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A five-year retrospective analysis of adherence in cystic fibrosis

Aarti Shakkottai1, Kelley M Kidwell2, Monica Townsend3

  • 1Pediatric Pulmonology, University of Michigan Health System, Ann Arbor, Michigan.

Pediatric Pulmonology
|September 9, 2015
PubMed

Insights

Medication adherence in children with cystic fibrosis (CF) varies by age, with younger children showing better adherence. Higher body mass index (BMI) is linked to improved adherence in CF patients.

Area of Science:

  • Pediatric Pulmonology
  • Pharmaceutical Sciences
  • Health Outcomes Research

Background:

  • Medication adherence is critical for managing chronic conditions like cystic fibrosis (CF).
  • Understanding adherence patterns in pediatric CF populations is essential for optimizing treatment outcomes.
  • Previous research has highlighted challenges in maintaining consistent medication adherence in children with CF.

Purpose of the Study:

  • To retrospectively analyze medication adherence and its association with health outcomes in children with CF over a 5-year period.
  • To investigate the relationship between adherence to CF medications and patient demographics, clinical factors, and health outcomes.
  • To identify factors influencing medication adherence across different age groups in pediatric CF patients.

Main Methods:

  • Retrospective analysis of prescription refill histories from specialty pharmacies for commonly prescribed CF medications.
  • Calculation of medication adherence by comparing filled prescriptions to prescribed supply over 12-month periods.
  • Binomial mixed effects modeling to assess longitudinal associations between adherence and age groups (0-5, 6-12, 13-21 years), controlling for confounders like gender, BMI, lung function, and hospitalization rates.

Main Results:

  • The youngest age group (0-5 years) exhibited the highest overall medication adherence (P = 0.009).
  • Children aged 6-12 years showed significantly better adherence to inhaled medications compared to oral medications (P = 0.020).
  • Higher body mass index (BMI) was strongly associated with increased odds of adherence across all age groups (P < 0.0001); no significant associations were found with gender, lung function, or hospitalization rates.

Conclusions:

  • Significant age-related differences in medication adherence exist in pediatric cystic fibrosis patients.
  • Enhanced adherence in younger children is likely influenced by increased parental supervision.
  • Improved nutritional status, indicated by higher BMI, is positively associated with better medication adherence in children with CF.
Abstract

Keywords:
adolescentsbody mass indexchildrencystic fibrosismedication adherencemedication possession ratiosprescription refill historiespulmonary exacerbationspulmonary function tests

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