Adherence, Mental Health and Illness Perceptions in Autoimmune Liver Disease: Looking Beyond Liver Function Tests.

Objectives: Autoimmune liver disease is commonly diagnosed during adolescence; a period associated with a higher prevalence of non-adherence, mental health concerns and worse health outcomes. The aim of the study was to explore adherence patterns, mental health and illness perceptions in young peopl...

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Publicado en:Journal of Pediatric Gastroenterology & Nutrition Vol. 73; no. 3; pp. 376 - 385
Autores principales: Hames, Anna, Matcham, Faith, Makin, Isobel, Day, Jemma, Joshi, Deepak, Samyn, Marianne
Formato: research Journal Article
Publicado: Wiley-Blackwell Sep2021
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2021
      vid: 73
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      pub: Wiley-Blackwell
      place: Malden, Massachusetts
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        atl: Adherence, Mental Health and Illness Perceptions in Autoimmune Liver Disease: Looking Beyond Liver Function Tests.
      aug:
        au:
          Hames, Anna
          Matcham, Faith
          Makin, Isobel
          Day, Jemma
          Joshi, Deepak
          Samyn, Marianne
        affil: Paediatric Liver, GI and Nutrition service, King's College Hospital NHS Foundation Trust, London, UK
      sug:
        subj:
          Liver Diseases
          Mental Health
          Young Adult
          Perception
          Liver Function Tests
          Human
          Adolescence
          Medication Compliance
          Cross Sectional Studies
          Adult
          Female
          Comparative Studies
          Multicenter Studies
          Evaluation Research
          Validation Studies
          Adolescent: 13-18 years
          Adult: 19-44 years
          Female
      ab: Objectives: Autoimmune liver disease is commonly diagnosed during adolescence; a period associated with a higher prevalence of non-adherence, mental health concerns and worse health outcomes. The aim of the study was to explore adherence patterns, mental health and illness perceptions in young people with autoimmune liver disease.Methods: Young people with autoimmune liver disease attending a multidisciplinary young adult clinic (16-25 years) completed an electronically administered questionnaire battery. Demographics and disease-related data were collected.Results: Sixty-eight (37 female), median age 17.9 (range 15-22) years completed the screening. Only 51.5% of patients were in remission (aspartate and alanine aminotransferase <36 IU//l) whereas 73% self-reported their adherence >80%. Compared to patients in remission, those not in remission required more immunosuppression, were more depressed and worried but reported a better understanding of their illness. A small but significant correlation was found between aspartate aminotransferase/alanine aminotransferase and adherence percentage (r = -0.27, P < 0.05 and r = -0.29, P < 0.05 respectively). Age was inversely associated with adherence (r = -0.31, P < 0.05), and older patients were more worried (r = 0.44, P < 0.001) and emotionally affected by the condition (r = 0.32, P < 0.01). Adherence behaviours such as forgetting to take medications (63%), taking medications more frequently before attending appointments (44%) and not having a routine for medications (31%) were prevalent, 7% reported intentional non-adherence.Conclusion: Sup-optimal adherence to treatment is common in young people with autoimmune liver disease and associated with mental health problems and certain illness perceptions. Routine exploration of adherence beliefs and barriers to adherence in a non-judgmental, collaborative way is essential to improve outcome in this vulnerable population.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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