TY - JOUR
T1 - Factors associated with adherence to nasoalveolar molding (NAM) by caregivers of infants born with cleft lip and palate
AU - Esmonde, Nick O.
AU - Garfinkle, Judah
AU - Chen, Yiyi
AU - Lambert, William
AU - Kuang, Anna
N1 - Publisher Copyright:
© The Author(s) 2017.
PY - 2018/2
Y1 - 2018/2
N2 - Objective: Identify factors associated with adherence to nasoalveolar molding (NAM) therapy. Design: Retrospective case-control study. Setting: Tertiary referral center. Patients, Participants: Infants with cleft lip, with or without cleft palate, referred for NAM. One hundred thirty-five patients met criteria. Main Outcome Measure(s): Adherence to NAM therapy, defined as continuous use of the appliance and attendance of NAM adjustment visits. Results: Female sex (OR = 2.85, 95% CI 1.21-6.74), bilateral cleft (OR = 2.88, 95% CI 1.29-6.46), and travel distance (OR = 1.01, 95% CI 1.00-1.01) were independent predictors of nonadherence. Bilateral clefts (OR = 8.35, 95% CI 2.72-25.64) and publicpayer insurance (OR = 3.67, 95% CI 1.13-11.91) for male patients were significantly associated with nonadherence, in our sexstratified multivariate model. The majority of the families (58%) had public health insurance. Males comprised 77.0% of the cohort. Conclusions: NAM treatment adherence is impaired by bilateral clefts, female sex, increased travel distance, and public insurance. Further studies are warranted to investigate how these factors affect adherence, and to develop interventions to improve adherence in families at risk due to economic or psychosocial barriers.
AB - Objective: Identify factors associated with adherence to nasoalveolar molding (NAM) therapy. Design: Retrospective case-control study. Setting: Tertiary referral center. Patients, Participants: Infants with cleft lip, with or without cleft palate, referred for NAM. One hundred thirty-five patients met criteria. Main Outcome Measure(s): Adherence to NAM therapy, defined as continuous use of the appliance and attendance of NAM adjustment visits. Results: Female sex (OR = 2.85, 95% CI 1.21-6.74), bilateral cleft (OR = 2.88, 95% CI 1.29-6.46), and travel distance (OR = 1.01, 95% CI 1.00-1.01) were independent predictors of nonadherence. Bilateral clefts (OR = 8.35, 95% CI 2.72-25.64) and publicpayer insurance (OR = 3.67, 95% CI 1.13-11.91) for male patients were significantly associated with nonadherence, in our sexstratified multivariate model. The majority of the families (58%) had public health insurance. Males comprised 77.0% of the cohort. Conclusions: NAM treatment adherence is impaired by bilateral clefts, female sex, increased travel distance, and public insurance. Further studies are warranted to investigate how these factors affect adherence, and to develop interventions to improve adherence in families at risk due to economic or psychosocial barriers.
KW - Cleft lip and palate
KW - Nasoalveolar molding
KW - Pediatric adherence
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U2 - 10.1177/1055665617718550
DO - 10.1177/1055665617718550
M3 - Article
C2 - 29351029
AN - SCOPUS:85047662006
SN - 1055-6656
VL - 55
SP - 252
EP - 258
JO - Cleft Palate-Craniofacial Journal
JF - Cleft Palate-Craniofacial Journal
IS - 2
ER -