OBJECTIVE The purpose of this study was to evaluate associations between executive functioning and caregiver adherence monitoring with objective antihypertensive medication adherence over 24 months in adolescents with chronic kidney disease (CKD). METHODS Adolescents (N = 97, 11-20 years old) with CKD taking antihypertensive medication and their caregivers were recruited from three pediatric nephrology clinics. At baseline, adolescents and caregivers reported on adolescents' executive functioning and caregivers reported on their adherence monitoring. Antihypertensive medication adherence was objectively assessed via electronic monitoring at baseline and every 6 months after for 24 months. Associations between executive functioning, caregiver monitoring, and longitudinal adherence were evaluated with linear mixed models. RESULTS Up to 38% of adolescents had elevated executive functioning scores indicating more severe impairments, with rates varying by scale and reporter (adolescent vs. caregiver). Caregiver monitoring showed a significant, negative association with adherence, but adolescents' executive functioning was not significantly associated with adherence. Neither variable was associated with the rate of change in adherence over time. CONCLUSIONS Given that adolescents' executive functioning was not associated with antihypertensive medication adherence or changes in adherence over time, adherence to daily pill-form medications may involve less cognitive effort than more complex medical regimens. Higher levels of caregiver monitoring were unexpectedly associated with lower adherence levels. This unanticipated finding may reflect increased caregiver monitoring efforts when faced with adolescents' medication nonadherence, but this finding warrants further investigation. Adolescents with CKD who are nonadherent may benefit from medication adherence-promoting strategies beyond increasing caregiver monitoring. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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慢性肾脏病青少年随时间推移的执行功能，看护者监控和药物依从性。

目的本研究的目的是评估慢性肾脏病（CKD）青少年在24个月内执行功能和护理者依从性监测与客观降压药物依从性之间的关联。方法从三个儿科肾脏病诊所招募患有CKD的青少年（N = 97，11-20岁）服用降压药，并为其护理人员。在基线时，青少年和照料者报告了青少年的执行功能，照料者报告了他们的依从性监测。在基线时以及每24个月后每6个月通过电子监测客观评估抗高血压药物的依从性。使用线性混合模型评估执行功能，照顾者监控和纵向依从性之间的关联。结果多达38％的青少年的执行功能评分升高，表明更严重的障碍，其比例因规模和报告者而异（青少年vs.照料者）。照护者监测显示与依从性存在显着的负相关性，但青少年的执行功能与依从性无显着相关性。这两个变量均与依从性随时间的变化率无关。结论鉴于青少年的执行功能与降压药物依从性或随时间变化的依从性无关，因此坚持每日服用药丸形式的药物可能比复杂的药物治疗方案少了认知工作。护理人员监控的较高水平出乎意料地与较低的依从性水平相关。这一意外的发现可能反映了当青少年未遵守药物治疗时，照料者监视工作的增加，但是这一发现值得进一步调查。不坚持治疗的CKD青少年可能会从增加依从性的药物支持策略中受益，而不仅仅是增加对照护者的监控。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。