Çocuklar ve ebeveynleri için kullanılacak ‘ilaç tedavisine uyunç’ ve ‘ilaca ilişkin hasta/hasta yakını yaklaşımı’ ölçeklerinin geliştirilmesi ve değerlendirilmesi

Abstract

It is known that the prescription rate of psychotropic drugs in adolescents is increasing, and medication adherence is lower in children and adolescents compared to adults. The effectiveness of psychotropic drugs is very important in terms of maintaining the health and quality of life of the pediatric patients, therefore, continuity of medication adherence should be considered. Among the parameters that may affect adherence are beliefs and thoughts about medications. Medication adherence in the pediatric population affects not only the children but also the whole family. Therefore, both parties should be notified in the evaluation of the adherence. It was aimed to develop the ‘Medication Adherence' scale to measure the patient's adherence, and to develop the 'Patient/Parent Attitudes Toward Medication' scales to better understand the patients' adherence/non-adherence to treatment. This study was carried out in Hacettepe University Faculty of Medicine, Child and Adolescent Psychiatry Outpatient Clinic, between December 2021 and April 2022. The scales were administered to 288 adolescents who were followed up with a psychiatric diagnosis and had been using psychotropic drugs for at least 2 months and 255 parents. In the validity analyzes of the scales, the content validity determined by taking expert opinion; construct validity was evaluated with explanatory factor analysis. In the reliability analysis, the Cronbach alpha internal consistency coefficient was calculated and the intraclass correlation coefficient was evaluated after the test-retest application. As a result of the analyses, the "Pediatric Medication Adherence" scale, which has a one-dimensional structure and consists of 9 questions for the patient and 6 questions for the parents, and the "Pediatric Attitudes to Medication" scale, consisting of 18 questions for the patient and 20 questions for the parent with the dimensions of necessity and anxiety have been developed. It has been shown that the scales are a valid and reliable (Cronbach's alpha >0.70). It was found that the patient's anxiety scores affected the attitudes towards the medication more significantly than the necessity scores, the parent's adherence scores and the patient's adherence scores were similar, the parent's negative attitude towards medication and the patient's adherence were correlated, and the parent and patient's negative attitudes toward medication were similar. It is important for clinicians to consider that the level of anxiety, side-effect profile, and polypharmacy will affect patients’ adherence and attitudes toward medication.