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@article{1548607,
author = {Oates, Gabriela R. and Štěpaníková, Irena and Rowe, Steven M. and Gamble, Stephanie and Gutierrez, Hector H. and Harris, William T.},
article_location = {IRVING},
article_number = {2},
doi = {http://dx.doi.org/10.4187/respcare.06436},
keywords = {adherence; airway clearance; chest physical therapy; high-frequency chest wall compressions; cystic fibrosis},
language = {eng},
issn = {0020-1324},
journal = {RESPIRATORY CARE},
title = {Objective Versus Self-Reported Adherence to Airway Clearance Therapy in Cystic Fibrosis},
url = {http://rc.rcjournal.com/content/64/2/176},
volume = {64},
year = {2019}
}
TY - JOUR
ID - 1548607
AU - Oates, Gabriela R. - Štěpaníková, Irena - Rowe, Steven M. - Gamble, Stephanie - Gutierrez, Hector H. - Harris, William T.
PY - 2019
TI - Objective Versus Self-Reported Adherence to Airway Clearance Therapy in Cystic Fibrosis
JF - RESPIRATORY CARE
VL - 64
IS - 2
SP - 176-181
EP - 176-181
PB - DAEDALUS ENTERPRISES INC
SN - 00201324
KW - adherence
KW - airway clearance
KW - chest physical therapy
KW - high-frequency chest wall compressions
KW - cystic fibrosis
UR - http://rc.rcjournal.com/content/64/2/176
L2 - http://rc.rcjournal.com/content/64/2/176
N2 - 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: 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: In the final sample (N = 110), mean adherence by usage data was 61%. Only 35% of subjects (n = 38) were highly adherent, and 28% (n = 31) were low adherent. In contrast, 65% of subjects (n = 72) reported high adherence and only 8% (n = 9) reported low adherence (P < .001). Nearly half of self-reports (46%) overestimated adherence. In a multiple regression analysis, overestimation was associated with multiple airway clearance therapy locations (odds ratio 7.13, 95% CI 1.16-43.72, P = .034) and prescribed daily use >= 60 min (odds ratio 3.85, 95% CI 1.08-13.76, P < .038). Among subjects with prescribed daily airway clearance therapy >= 60 min, the odds of overestimating adherence increased 3-fold (odds ratio 3.04, 95% CI 1.17-7.87, P = .02) in a lower-income (< $50,000/y) environment. 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.
ER -
OATES, Gabriela R., Irena ŠTĚPANÍKOVÁ, Steven M. ROWE, Stephanie GAMBLE, Hector H. GUTIERREZ and William T. HARRIS. Objective Versus Self-Reported Adherence to Airway Clearance Therapy in Cystic Fibrosis. \textit{RESPIRATORY CARE}. IRVING: DAEDALUS ENTERPRISES INC, 2019, vol.~64, No~2, p.~176-181. ISSN~0020-1324. Available from: https://dx.doi.org/10.4187/respcare.06436.
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