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Yıl:2022; Cilt: 29; Sayı: 2>> Özet
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Çocuk ve Gençlik Ruh Sağlığı Dergisi; 2022;29(2):84-92
Dikkat Eksikliği Hiperaktivite Bozukluğunda Metilfenidat Tedavisine Uyumu Etkileyen Faktörler: Retrospektif Bir Çalışma
MK Kale, Ş Yalın Sapmaz, T Erten, E Akar, Ö Bilaç, H Kandemir
Manisa Celal Bayar Üniversitesi Tıp Fakültesi, Manisa,
Amaç: Araştırmamızda dikkat eksikliği hiperaktivite bozukluğu (DEHB) tanısıyla ilk kez medikal tedavi başlanan çocuklarda, tedaviye uyumu belirlemeyi ve uyumu etkileyen sosyo-demografik ve klinik faktörleri incelemeyi amaçladık. Gereç ve Yöntem: 2018-2020 yılları arasında DEHB tanısı konup ilk defa medikal tedavi alan çocuk veya ergenler çalışmaya alınıp, tedaviye uyumları belirlendi ve uyumu etkileyen faktörler araştırıldı. Hastaların sosyo-demografik, verilerini, DEHB ve komorbid psikiyatrik bozukluklarla ilgili bilgilerini içeren bir bilgi formu oluşturuldu. Veriler klinik takip dosyalarından geriye dönük tarama yapılarak elde edildi. Altı aydan fazla tedaviye devam edenler uyumlu, 6 aydan az olanlar ise uyumsuz olarak kabul edildi ve bu verilerle değerlendirilerek uyumu etkileyen faktörler araştırıldı. Bulgular: Çalışmaya 338 kişi dahil edildi. Altıncı ayın sonunda uyum oranı %48,2 olarak bulundu. Tedaviye uyumsuz grupta yaş ortalaması daha yüksekti. İki grup arasında yaş, ailede psikiyatrik bozukluk varlığı ve ilaç kullanımı, tedavi ile ders başarısının değişmesi, komorbid yıkıcı davranış bozukluğunun varlığı, birden fazla komorbid psikiyatrik bozukluk varlığı ve yan etkilerin çıktığı süre ile ilgili anlamlı fark bulundu. Regresyon analizi sonucunda ailede psikiyatrik bozukluk varlığı, tedavi ile ders başarısının değişmesi, yan etkilerin çıktığı süre ve tedavi uyumu arasındaki ilişki modelde anlamlı olarak kaldı. Sonuç: DEHB tanısı konmuş olgularda yaş, ailede psikiyatrik bozukluk varlığı ve ilaç kullanımı, birden fazla komorbid psikiyatrik bozukluk varlığı, tedavi ile ders başarısının değişmesi, yan etkilerin çıkma zamanı tedaviye uyumu etkileyebilmektedir. Bu durum tedaviye başlanacak hastalarda dikkate alınmalıdır.
Factors That Affect Methylphenidate Treatment Adherence in Attention Deficit Hyperactivity Disorder: A Retrospective Study
Objectives: In our research, we aimed to determine treatment adherence and examine socio-demographic and clinical factors that affect it in pediatric patients firstly given medical treatment for the diagnosis of attention deficit hyperactivity disorder (ADHD). Materials and Methods: Between 2018 and 2020, children and adolescents who were first diagnosed with ADHD were enrolled in our study and factors that affect treatment adherence were investigated. A data form including socio-demographic, ADHD and clinical data of patients was created. Those data were extracted by retrospective search of clinical records. Patients who continued the treatment for six or more months were accepted as adherent, those who did not continue were accepted as non-adherent. Factors affecting treatment adherence were evaluated. Results: Three hundred and thirty-eight patients were included in our research. At the end of the sixth month, adherence rate was 48.2%. The average age was higher in the non-adherent group. Between the adherent and non-adherent groups, age, psychiatric disorder and psychiatric treatment in family, time of the onset of side effects, presence of comorbid destructive behavior disorders, presence of multiple comorbid disorders, and change in academic achievement with treatment were statistically significant differences. As a result of the regression analysis, the relationship between the presence of psychiatric disorders in the family, change in the course success with treatment, time of the onset of side effects and treatment compliance remained significant in the model. Conclusion: After the diagnosis of ADHD, age, psychiatric disorder and treatment in family, time of the onset of side effects, change in course success with treatment, presence of comorbid destructive behavior disorders, and presence of multiple comorbid disorders could affect the treatment adherence. This situation should not be ignored when the treatment was started to patients.

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