Current Interventions to Improve Adherence to Immunosuppressants in Liver Transplant Recipients: a Systematic Review

Abstract

Adherence to immunosuppressants is the key to prevent organ rejection in organ transplant recipients. The purpose of this study was to investigate current interventions to improve adherence to immunosuppressants in liver transplant recipients. Methods: A systemic literature search was done using PubMed, Embase, Cochrane Library, CINAHL and four Korean databases to identify experimental studies reported in English or Korean up to and including 2015. We identified eight intervention studies on the adherence to immunosuppressants in liver transplant recipients independently reviewed by two reviewers. The quality and risk of bias of the selected studies were assessed. Results: Education, conversion of regimen, and text messaging were identified as intervention techniques to improve adherence. We found positive results in three out of four studies implementing educational strategies, but the results were not sufficient to draw a definite conclusion. Conversion from a twice-daily tacrolimus-based regimen to a once-daily tacrolimus extended-release formula was used in three adult-only studies and its effectiveness was confirmed. One study showed that improved adherence and outcomes were effected by using text messaging with pediatric patients. Conclusion: Future research is needed to facilitate interventions to improve adherence to immunosuppressants in various ages of patients including pediatric/adolescent liver transplant recipients.

Relationship between Readiness for Hospital Discharge and Self-care of Liver Transplant Recipients: A Single-center Prospective Study

“…특정 행동을 수행 할 수 있는 능력과 신념을 자기효능감이라 하는데, 일반적으로 이식 수혜자의 경우, 자기효능감이 높을 수록 자가간호 이행도가 높다고 보고된 바 있다 [14,15]. 퇴원 후 간이식 수혜자에게 요구되는 자가간 호 행위는 이식성공의 관점에서 중요한 요인이다 [16]. 따라서, 추후 퇴원 후 수혜자의 자가간호와 그 영향요인을 파악하는 연구는 간 기능 유지 및 건강 향상을 위해 장기적인 관점에서 이뤄져야 한다.…”