Evidence map›Paper›PMID 27875025›Full record

Trial reportPediatric pulmonology2017

Adherence and barriers to hyperinsufflation in children with congenital muscular dystrophy.

John E Pascoe, Hemant Sawnani, Oscar H Mayer, Keith McConnell, Joseph M McDonough, Cynthia White, Anne M Rutkowski, Raouf S Amin, Avani C Modi

Abstract readMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in Pediatric pulmonology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trial
  2. Trial
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

John E PascoeDivision of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Hemant SawnaniDivision of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Oscar H MayerDivision of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Keith McConnellDivision of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Joseph M McDonoughDivision of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania.
Cynthia WhiteDivision of Respiratory Therapy, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Anne M RutkowskiCure CMD and Kaiser SCPMG, Harbor City, California.
Raouf S AminDivision of Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Avani C ModiDivision of Behavioral Medicine and Clinical Psychology, Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

Funding

Enhancing treatment adherence and health outcomesT32HD068223 · NICHD · CINCINNATI CHILDRENS HOSP MED CTR · PI Kevin Hommel, Meghan Eileen McGrady · 2012 to 2026
$3.6M
Passive stretch of the chest wall in patients with Congential Muscular DystrophyR34HL113390 · NHLBI · CINCINNATI CHILDRENS HOSP MED CTR · PI AMIN, RAOUF S. · 2013 to 2014
$700k
NHLBI NIH HHS R34 HL113390NICHD NIH HHS T32 HD068223
6 · The paper itself

Abstract

backgroundCongenital muscular dystrophy (CMD) is a rare, inherited neuromuscular disease characterized by progressive muscle weakness, thoracic insufficiency, and ultimately respiratory failure. Adherence to respiratory therapies in children with neuromuscular disorders is unknown. This study examined the multimodal assessment of adherence and barriers to 15 min, twice daily hyperinsufflation in children with CMD. Adherence was hypothesized to be greater than 50% and discomfort, embarrassment, and difficulty finding time were hypothesized to be barriers.

methodsParticipants included 18 children with CMD. Personalized hyperinsufflation settings were determined based on pressure-volume measurements at each study visit. Adherence was measured by a daily phone diary (DPD) and by electronic data download from the hyperinsufflation device. The DPD was conducted twice over a 48-hr period to capture a weekend and weekday, with the goal being 60 min of hyperinsufflation over the 48 hr (100% adherence). The hyperinsufflation objective electronic data reflected daily use of hyperinsufflation for the same 48-hr period. Data from DPD and the corresponding hyperinsufflation device data were used for analyses.

resultsAdherence to hyperinsufflation was 40% via DPD and 44% for electronic data, with strong convergence between methods (r = 0.75, P < 0.001). Surprisingly, 53% of participants reported no barriers despite low adherence. Social distractions and family obligations were identified as barriers. There were no differences in adherence between those who did and did not endorse barriers to hyperinsufflation (DPD: t(13) = 0.44, P = n.s.; hyperinsufflation device: t(13) = -0.23, P = n.s.).

conclusionAdherence to hyperinsufflation is a significant problem in children with CMD and families have difficulty identifying adherence barriers. An important next step is to encourage open dialog around adherence barriers and promote adherence behaviors via intervention. Pediatr Pulmonol. 2017; 52:939-945. © 2016 Wiley Periodicals, Inc.

Indexed as

Patient ComplianceRespiratory TherapyAdolescentChildFemaleHumansMaleMuscular DystrophiesRespiratory InsufficiencychildrenCMDcough assistfacilitatorshyperinsufflationpulmonary functionrestrictive lung disease

Identifiers

PMID27875025
PMCPMC6827716

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.