Describing barriers and facilitators for medication adherence and self‐management among kidney transplant recipients using the information‐motivation‐behavioral skills model

Ranahan, Molly; Visger, Jon Von; Kayler, Liise K.

doi:10.1111/ctr.13862

Cited by 20 publications

(14 citation statements)

References 81 publications

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“…Some of our patients described linking their medication taking to an already established sequence of behaviours, such as preparing and eating breakfast. This behaviour is colloquially termed ‘habit stacking’ [ 25 ], and has been shown to have a positive impact on adherence [ 31 ]. Some of our patients had linked their medication taking to habits that shifted post-transplant, or were not daily, and thus, their process of habit stacking was sometimes ineffective.…”

Section: Discussionmentioning

confidence: 99%

Exploring Transplant Medication-Taking Behaviours in Older Adult Kidney Transplant Recipients: A Qualitative Study of Semi-Structured Interviews

et al. 2022

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Background Today, older adult patients routinely undergo kidney transplantation. To support graft survival, patients must take immunosuppressant medicines for the rest of their lives. The post-transplant medication regimen is complex, and barriers to medication taking are likely confounded by both functional and intrinsic changes associated with advancing age. To develop diverse and innovative approaches to support best health outcomes in this vulnerable age group, it is imperative that the degree to which patients' needs are currently being met, be identified. Aim The aim of this study was to examine medication-taking behaviours of kidney transplant recipients transplanted at 60 years of age or older. Methods This qualitative study used semi-structured patient interviews to explore how kidney transplant recipients currently manage their immunosuppressant regimen and how they cope after transplantation with the complex routine. Data were themed using the principles of Grounded Theory methodology; with interviews conducted until data saturation was reached. Results Quantitative information was collected from 14 participants who ranged in age from 66 to 77 years (at time of interview), and were prescribed a median of 13 (min: 10, max: 26) medicines. The main themes that emerged from the interview were variability in health literacy toward medicines, the importance of support networks, the need to adjust health expectations, factors that were motivators for self-care, different approaches to medication management, and different approaches to medication taking. Overall, it was found that patients prioritised medication taking above all else, and gratitude to their donor was a powerful motivator to adhere. However, strategies to support medication taking were sometimes ineffective when patients' routine changed. Conclusions Future interventions should consider approaches to foster adaptable medication taking behaviours that stand up to changes in the day-to-day routine. Plain Language SummaryMedication taking is complicated in transplant recipients, due to the number of medicines that need to be taken and the complex nature of the treatment regimen. Challenges in older transplant recipients may be more pronounced and varied compared with younger adults. There are multiple factors that may impact medication taking in older adults and each requires consideration, including level of dependence, living arrangements, level of mobility and manual dexterity, vision and memory, and social situation. To better identify the gaps in support, patients' current perspectives around medication taking and how they cope after transplantation must be explored. Therefore, this study aimed to identify how older adult transplant recipients currently manage their anti-rejection medicine regimen. Participants described several strategies around how they manage a complex medication regimen. These included cues such as an alarm and linking the time they should take their

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Section: Discussionmentioning

confidence: 99%

Exploring Transplant Medication-Taking Behaviours in Older Adult Kidney Transplant Recipients: A Qualitative Study of Semi-Structured Interviews

et al. 2022

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“…The number of KTs performed in the United States has increased 78% from 1999 to 2020, with over 22,817 performed in 2020 based on data from the Organ Procurement and Transplantation Network National Data website for KTs by Donor Site accessed on August 1, 2021 (https://optn.transplant.hrsa.gov/data/view-data-reports/national-data/). However, long-term outcomes remain suboptimal, and strengthening self-management behaviors of KT recipients may prove useful (Legendre et al, 2014; Ranahan et al, 2020). To our knowledge, this study is the first to provide evidence that psychological (SEMCD and patient activation) and clinical factors (years post-KT and years of dialysis) impact kidney recipients’ self-management behaviors.…”

Section: Discussionmentioning

confidence: 99%

The Kidney Transplant Self-Management Scale: Instrument Development and Psychometric Testing

et al. 2022

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This study reports the development and psychometric testing of the Kidney Transplant Self-Management Scale (KT-SMS). The instrument development phase included the following: (a) conceptual definition, item generation, and framework; (b) face validity assessment; and (c) content validity assessment. The psychometric testing phase included the following: (a) construct validity testing; (b) internal consistency reliability testing; (c) convergent validity testing; and (d) predictive power of the KT-SMS using a cross-sectional sample of kidney transplant recipients ( N = 153). Factor analysis results supported the 16-item KT-SMS as multidimensional with five domains (medication adherence, cardiovascular risk reduction, protecting kidney, ownership, and skin cancer prevention). Internal consistency reliability for the total scale and five subscales was adequate. Convergent validity was supported as the intercorrelations of the KT-SMS total score with the five subscales were significant. The KT-SMS total score and five subscales were significantly correlated with self-efficacy for managing chronic disease, patient activation, and health-related quality of life.

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“…In fact, as early as 10 years ago, scholars proposed the Information, Motivation and Behavioral Skills (IMB) Model, which has guiding signi cance in HIV risk reduction interventions [26]. The information in the IMB model mainly includes subjective information and objective information, of which objective information includes knowledge [27].…”

Section: Discussionmentioning

confidence: 99%

Study on Influencing Factors to HIV Health Services Among Men Who Have Sex with Men (MSM) from 2013 to 2021

Lin

Jia-xiu

Pan

et al. 2021

Preprint

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Background We assessed the utilization of HIV health services and its influencing factors on consistent condom use, HIV testing and HIV counseling among men who have sex with men (MSM) based on Andersen Behavioral Model, so as to provide a theoretical basis for future infectious disease prevention and control strategies and health services policy formulation.method This is a cross-sectional study from 2013 to 2021. A sample survey was conducted in southwest China including Chongqing, Sichuan, Xinjiang and Guangxi, and an anonymous self-administered questionnaire survey was conducted among MSM who met the requirements and were recruited. Based on Anderson Behavioral Model, the questionnaire divided the influencing factors into predisposing factor, enabling factor and need factor. There were 2908 valid questionnaires. Multivariate logistic regression analysis was used to explore the factors influencing the utilization of health services.Results In the survey of HIV health services, 36.49% of respondents consistently used condoms, 82.81% had HIV testing, and 65.61% had HIV counseling. It can be obtained that among the predisposing factor, older age is a factor that promotes HIV testing but is a hindrance to consistent condom use. Condom use was higher among MSM who were Ethnic Han and had an education level of "junior high or below". Among the enabling factor, not finding a sexual partner through the Internet, not having commercial sex were associated with consistent condom use. Urban and high income were enablers of HIV testing and HIV counseling. Among the need factor, improved HIV knowledge could promote HIV testing and HIV counseling among MSM.Conclusions For these groups, MSM with high-risk characteristics should be identified as a priority in the future public health services. HIV knowledge should be promoted in health education, and mental health diagnosis and treatment also should be strengthened.

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Describing barriers and facilitators for medication adherence and self‐management among kidney transplant recipients using the information‐motivation‐behavioral skills model

Cited by 20 publications

References 81 publications

Exploring Transplant Medication-Taking Behaviours in Older Adult Kidney Transplant Recipients: A Qualitative Study of Semi-Structured Interviews

Exploring Transplant Medication-Taking Behaviours in Older Adult Kidney Transplant Recipients: A Qualitative Study of Semi-Structured Interviews

The Kidney Transplant Self-Management Scale: Instrument Development and Psychometric Testing

Study on Influencing Factors to HIV Health Services Among Men Who Have Sex with Men (MSM) from 2013 to 2021

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