Predictors of medical adherence following a bowel management program for youth and young adults with Spina Bifida
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In brief
In brief
This study examines factors affecting bowel regimen adherence in youth with Spina Bifida after completing a bowel management program. Neighborhood socioeconomic disadvantage emerged as the strongest predictor of non-adherence, suggesting that area deprivation index scores could help identify high-risk patients for proactive intervention.
- Neighborhood disadvantage (ADI) strongly predicts bowel regimen non-adherence in youth with Spina Bifida after bowel management programs.
- Each decile increase in neighborhood disadvantage associated with 48% decreased odds of adherence (OR=0.52, p=.005).
- Community socioeconomic factors outweighed individual demographics in predicting adherence outcomes.
- 15.5% non-adherence rate observed in pediatric SB population (mean age 8 years) following structured bowel management intervention.
- ADI screening may identify high-risk patients needing proactive adherence support and tailored follow-up interventions.
Written by the GCMD Library team from the article.
Abstract
Purpose
To evaluate individual and community sociodemographic factors that predict bowel regimen adherence in youth and young adults with Spina Bifida (SB) following participation in a bowel management program (BMP).
Methods
Participants were drawn from clinical cases seen through an International Center for Colorectal and Urogenital Care. Area deprivation index (ADI) scores were extracted from participant addresses and bowel regimen adherence data were collected from the electronic medical record (EMR).
Results
Participants’ mean age was 8.06 years old, 51.7% were male, 72.4% white, 37.9% Hispanic, 56.9% government insurance, 89.7% myelomeningocele, 15.5% non-adherent. Average neighborhood disadvantage was 5.19 (SD:2.83, range:1–10). After controlling for variables correlated with adherence (p < .20), every one decile higher neighborhood disadvantage score was associated with a 48% decrease in the odds of being adherent (OR = 0.52, p = .005, 95% CI: − 101.90, − 0.21).
Conclusion
Our results suggest that neighborhood disadvantage is a strong predictor of medical adherence following a BMP, more so than other sociodemographic and health-related variables. These results may assist with identifying which individuals may be at higher risk for poor health outcomes due to neighborhood socioeconomic disadvantage and help health care systems intervene proactively.