Efficacy of Interventions for Adherence to the Immunosuppressive Therapy in Kidney Transplant Recipients: A Meta-Analysis and Systematic Review

Zhu, Yichen; Zhou, Yifan; Zhang, Lei; Zhang, Jiän; Lin, Jun

doi:10.1136/jim-2016-000265

Cited by 49 publications

(38 citation statements)

References 35 publications

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“…Non-adherence seems to be related to the complexity of medical prescriptions, the individual and clinical characteristics of the patient (personality traits, pre-transplant lifestyle including diet, physical activity, a long duration of dialysis) (36,39,46,48). Moreover, it is important that the transplanted person accepts the support of their family and collaborates with the transplant team to adhere to the new lifestyle, such as the resumption of healthy exercise (37,49,57,80). Also the return to work after a kidney transplant is an important indicator of psychophysical well-being (74,83).…”

Section: Discussionmentioning

confidence: 99%

“…Future directions of research should focus on deepening all those factors (self-efficacy, awareness disease, social and family support, health education) that influence the transplant preparation pathway and post-transplant results (32,80). Furthermore, the development of interdisciplinary interventions with the various specialists (surgeon, nephrologist, psychiatrist and psychologist) would be desirable to identify shared operational protocols for integrated care of the transplanted patient and also plan training and updating courses for the "health team" with particular attention to psychological, communicative and relational aspects (24,62,64,67,68,70,(75)(76)(77).…”

Section: Discussionmentioning

confidence: 99%

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Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

et al. 2020

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Kidney transplantation is a serious event that involves profound psychological, relational and social changes both for the patient and his family context. Assessment of personality profile, awareness of disease, family and social support of the patient candidate for kidney transplantation are necessary because factors not adequately considered, can influence the success of the transplant and alter the psychological stability of the patient. The present study aims to provide a systematic review of the literature of the last twelve years (2006-2018), focusing in particular on patient's readiness level and illness management and on possible psychopathology. Sixty-two studies were examined. Based on the Downs and Black checklist, most studies (n = 32) were of high quality; 15 of which related to lifestyle, health education, and therapeutic adherence in post-renal transplantation, 17 studies concerned the possible existence of psychopathology and cognitive impairment of renal deceased transplanted subjects. The literature used has shown that the population of kidney transplant patients is exposed to a high risk of psychiatric disorders with repercussions on the quality of life and the risk of rejection. Therefore, an adequate pre-transplant psychosocial assessment is necessary, which allows a more indepth knowledge of the candidate to plan coping strategies and possible posttransplant psychotherapy.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

et al. 2020

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“…The intervention studies conducted to date have focused on more traditional interventions and have demonstrated that these have a modest effect on medication adherence. In fact, in a meta-analysis of 8 studies involving 546 patients who received intervention through a pharmacist, intervention groups, or continuing education, Zhu et al found that adherence rates and adherence scores were significantly higher for the EG than for the CG [29].…”

Section: Discussionmentioning

confidence: 99%

Web-Based Tailored Intervention to Support Optimal Medication Adherence Among Kidney Transplant Recipients: Pilot Parallel-Group Randomized Controlled Trial

Côté¹,

Fortin²,

Auger³

et al. 2018

JMIR Formativ Res

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BackgroundOptimal immunosuppressive medication adherence is essential to graft survival. Transplant-TAVIE is a Web-based tailored intervention developed to promote this adherence.ObjectiveThe objective of our study was to evaluate the Transplant-TAVIE intervention’s acceptability, feasibility, and preliminary efficacy.MethodsIn a pilot, parallel-group, randomized controlled trial, we randomly assigned a convenience sample of 70 kidney transplant patients on immunosuppressive medication either to an experimental group (Transplant-TAVIE) or to a control group (existing websites). Kidney transplant recipients had to be older than 18 years, be taking immunosuppressant medication, and have access to the internet to participate in this study. Transplant-TAVIE was composed of three interactive Web-based sessions hosted by a virtual nurse. We documented user appreciation of and exposure to the intervention. Furthermore, we assessed medication adherence, medication self-efficacy, intake-related skills, and medication side effects at baseline and 3 and 6 months later. Analyses of variance were used to assess intergroup differences over time.ResultsAfter baseline questionnaire completion, participants were randomly assigned either to Transplant-TAVIE (n=35) or to the websites (n=35) group. All participants had received their kidney graft <1 year to 32 years earlier (mean 6.8 years). Of the experimental group, 54% (19/35) completed the sessions of Transplant-TAVIE. Users found the intervention to be acceptable—33% were extremely satisfied (6/18), 39% were very satisfied (7/18), and 28% were satisfied (5/18). At baseline and over time, both experimental and control groups reported high medication adherence, high medication self-efficacy, and frequent use of skills related to medication intake. No intergroup differences emerged over time.ConclusionsThe results of this study support the feasibility and acceptability of Transplant-TAVIE. It could constitute an accessible adjunct in support of existing specialized services.

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“…Although the details of the use of eHealth interventions for improving medication adherence by organ transplant patients are currently of great interest, there have been no systematic review and meta-analysis studies published focusing on the effects of eHealth interventions. Additionally, meta-analyses of the various interventions applied with organ transplant patients have been conducted, and the results have been effectively reported [24][25][26], but no study to date has separately analyzed eHealth interventions. Therefore, this study aimed to evaluate the effects of eHealth interventions on improving medication adherence and knowledge when applied to organ transplant patients, as compared to typical or conventional care, and to conduct a systematic review and meta-analysis to provide guidance on how eHealth interventions for organ transplant recipients should be organized to be effective.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of eHealth interventions for improving medication adherence of organ transplant patients: A systematic review and meta-analysis

2020

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Background Organ transplantation is the most effective treatment for patients with end-stage organ failure. It has been actively carried out all over the world. Recently, eHealth interventions have been applied to organ transplant patients. This systematic review and meta-analysis aimed to evaluate the effects of eHealth interventions for improving medication adherence in organ transplant patients as compared to usual or conventional care alone. Methods We searched MEDLINE via PubMed, Excerpta Media dataBASE (EMBASE), the Cochrane Register Controlled Trials, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO, and six domestic Korean databases to identify randomized controlled trials (RCTs) published up to April 17, 2020. Two reviewers independently selected relevant studies and extracted data. The quality and bias of the identified studies were assessed. To estimate the effect size, a meta-analysis of the studies was performed using the Cochrane Collaboration software Review Manager 5.3. PRISMA guidelines were followed. When statistical heterogeneity was greater than 80%, narrative synthesis was performed. Results Of the 1,847 articles identified, seven RCTs with a total of 759 participants met the inclusion criteria. The risk of bias assessment showed that the blinding of participants and personnel was high. In six studies, medication adherence (effect size = -0.18–1.30) and knowledge scores were not significantly different between those receiving eHealth interventions and the controls. Conclusions Our findings suggest that eHealth interventions were similar to standard care or advanced care for improving medication adherence, and they faired equally well for improving medication knowledge. Therefore, eHealth interventions can be used for medication adherence of organ transplant patients. More research is needed to provide well-designed eHealth intervention to improve the medication adherence and knowledge of organ transplant patients. Protocol registration number CRD42017067145 16/05/2017

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Efficacy of Interventions for Adherence to the Immunosuppressive Therapy in Kidney Transplant Recipients: A Meta-Analysis and Systematic Review

Cited by 49 publications

References 35 publications

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Psychological and Psychopathological Aspects of Kidney Transplantation: A Systematic Review

Web-Based Tailored Intervention to Support Optimal Medication Adherence Among Kidney Transplant Recipients: Pilot Parallel-Group Randomized Controlled Trial

Effectiveness of eHealth interventions for improving medication adherence of organ transplant patients: A systematic review and meta-analysis

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