Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease

on behalf of the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module Testing Study Consortium

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)1-10
Number of pages10
JournalQuality of Life Research
DOIs
StateAccepted/In press - Sep 8 2017

Fingerprint

Medication Adherence
Inflammatory Bowel Diseases
Quality of Life
Pediatrics
Health Communication
Constipation
Diarrhea
Stomach
Pain
Health Personnel
Communication
Regression Analysis
Demography
Equipment and Supplies

Keywords

  • Crohn’s disease
  • Gastrointestinal symptoms
  • Inflammatory bowel disease
  • Medication adherence barriers
  • Patient communication
  • PedsQL
  • Ulcerative colitis

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

Cite this

Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease. / on behalf of the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module Testing Study Consortium.

In: Quality of Life Research, 08.09.2017, p. 1-10.

Research output: Contribution to journalArticle

on behalf of the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module Testing Study Consortium. / Perceived medication adherence barriers mediating effects between gastrointestinal symptoms and health-related quality of life in pediatric inflammatory bowel disease. In: Quality of Life Research. 2017 ; pp. 1-10.
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abstract = "Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.",
keywords = "Crohn’s disease, Gastrointestinal symptoms, Inflammatory bowel disease, Medication adherence barriers, Patient communication, PedsQL, Ulcerative colitis",
author = "{on behalf of the Pediatric Quality of Life Inventory™ Gastrointestinal Symptoms Module Testing Study Consortium} and Varni, {James W.} and Shulman, {Robert J.} and Self, {Mariella M.} and Saeed, {Shehzad A.} and Zacur, {George M.} and Patel, {Ashish S.} and Samuel Nurko and Neigut, {Deborah A.} and Franciosi, {James P.} and Miguel Saps and Denham, {Jolanda M.} and Dark, {Chelsea Vaughan} and Bendo, {Cristiane B.} and Pohl, {John F.} and Varni, {James W.} and Jolanda Denham and Shulman, {Robert J.} and Self, {Mariella M.} and Neigut, {Deborah A.} and Samuel Nurko and Patel, {Ashish S.} and Franciosi, {James P.} and Shehzad Saeed and Zacur, {George M.} and Miguel Saps and Barbara Verga and Pohl, {John F.}",
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AU - Shulman, Robert J.

AU - Self, Mariella M.

AU - Saeed, Shehzad A.

AU - Zacur, George M.

AU - Patel, Ashish S.

AU - Nurko, Samuel

AU - Neigut, Deborah A.

AU - Franciosi, James P.

AU - Saps, Miguel

AU - Denham, Jolanda M.

AU - Dark, Chelsea Vaughan

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AU - Denham, Jolanda

AU - Shulman, Robert J.

AU - Self, Mariella M.

AU - Neigut, Deborah A.

AU - Nurko, Samuel

AU - Patel, Ashish S.

AU - Franciosi, James P.

AU - Saeed, Shehzad

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AU - Pohl, John F.

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N2 - Objectives: 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. Methods: 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. Results: 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. Conclusions: 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.

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KW - Crohn’s disease

KW - Gastrointestinal symptoms

KW - Inflammatory bowel disease

KW - Medication adherence barriers

KW - Patient communication

KW - PedsQL

KW - Ulcerative colitis

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