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ARS Home » Plains Area » Houston, Texas » Children's Nutrition Research Center » Research » Publications at this Location » Publication #349409
Title: Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease

Author
item VARNI, JAMES - TEXAS A&M UNIVERSITY
item SHULMAN, ROBERT - CHILDREN'S NUTRITION RESEARCH CENTER (CNRC)
item SELF, MARIELLA - BAYLOR COLLEGE OF MEDICINE
item SAEED, SHEHZAD - CHILDREN'S HOSPITAL - CINCINNATI, OHIO
item ZACUR, GEORGE - CHILDREN'S HOSPITAL - CINCINNATI, OHIO
item PATEL, ASHISH - UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER
item NURKO, SAMUEL - BOSTON CHILDREN'S HOSPITAL
item NEIGUT, DEBORAH - CHILDREN'S HOSPITAL - DENVER, COLORADO
item FRANCIOSI, JAMES - CHILDREN'S HOSPITAL - CINCINNATI, OHIO
item SAPS, MIGUEL - NORTHWESTERN UNIVERSITY
item DENHAM, JOLANDA - COLUMBUS CHILDREN'S HOSPITAL
item DARK, CHELSEA - TEXAS A&M UNIVERSITY
item BENDO, CRISTIANE - FEDERAL UNIVERSITY OF MINAS GERAIS
item POHL, JOHN - UNIVERSITY OF UTAH

Submitted to: Quality of Life Research
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 9/2/2017
Publication Date: 9/8/2017
Citation: Varni, J.W., Shulman, R.J., Self, M.M., Saeed, S.A., Zacur, G.M., Patel, A.S., Nurko, S., Neigut, D.A., Franciosi, J.P., Saps, M., Denham, J.M., Dark, C.V., Bendo, C.B., Pohl, J.F. 2017. Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease. Quality of Life Research. https://doi.org/10.1007/s11136-017-1702-6.

Interpretive Summary: Over a million people in the United States, of which over 200,000 are children, suffer from inflammatory bowel disease, a condition that causes irritation in the intestine and poor nutrition. The condition also causes abdominal pain and diarrhea. These symptoms negatively impact the quality of life of people with inflammatory bowel disease. In this study we found that difficulties that children found in taking their medications contributed significantly to a poor quality of life; overcoming this barrier would improve the quality of life of these children. Our results also indicate that improving health communication between the child and the health care provider also could contribute to a better quality of life in these children and better outcomes including, likely, better nutritional status and growth.

Technical Abstract: The primary objective was to investigate the mediating effects of patient-perceived medication adherence barriers in the relationship between gastrointestinal symptoms and generic health-related quality of life (HRQOL) in adolescents with inflammatory bowel disease (IBD). The secondary objective explored patient health communication and gastrointestinal worry as additional mediators with medication adherence barriers in a serial multiple mediator model. The Pediatric Quality of Life Inventory Gastrointestinal Symptoms, Medicines, Communication, Gastrointestinal Worry, and Generic Core Scales were completed in a 9-site study by 172 adolescents with IBD. Gastrointestinal Symptoms Scales measuring stomach pain, constipation, or diarrhea and perceived medication adherence barriers were tested for bivariate and multivariate linear associations with HRQOL. Mediational analyses were conducted to test the hypothesized mediating effects of perceived medication adherence barriers as an intervening variable between gastrointestinal symptoms and HRQOL. The predictive effects of gastrointestinal symptoms on HRQOL were mediated in part by perceived medication adherence barriers. Patient health communication was a significant additional mediator. In predictive analytics models utilizing multiple regression analyses, demographic variables, gastrointestinal symptoms (stomach pain, constipation, or diarrhea), and perceived medication adherence barriers significantly accounted for 45, 38, and 29 percent of the variance in HRQOL (all Ps < 0.001), respectively, demonstrating large effect sizes. Perceived medication adherence barriers explain in part the effects of gastrointestinal symptoms on HRQOL in adolescents with IBD. Patient health communication to healthcare providers and significant others further explain the mechanism in the relationship between gastrointestinal symptoms, perceived medication adherence barriers, and HRQOL.