Evaluating non‐adherence to immunosuppressant medications in pediatric liver transplant recipients

Stuber, Margaret L.; Shemesh, Eyal; Seacord, Debra; Washington, James; Hellemann, Gerhard; McDiarmid, S. V.

doi:10.1111/j.1399-3046.2008.00923.x

Cited by 90 publications

(98 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In liver transplantation, the effect of non-adherence on graft outcomes has been well studied in pediatric and adolescent transplant recipients [7][8][9][10][11]. Among adults, various international studies have attempted to measure non-adherence to IS therapy using self-reported non-adherence [12] and electronic medication monitoring [13], with the majority of patients found to be adherent to IS therapy.…”

Section: Introductionmentioning

confidence: 99%

Non-Adherence and Graft Failure in Adult Liver Transplant Recipients

2012

View full text Add to dashboard Cite

show abstract

Section: Introductionmentioning

confidence: 99%

Non-Adherence and Graft Failure in Adult Liver Transplant Recipients

2012

View full text Add to dashboard Cite

show abstract

“…The calcineurin inhibitors, such as cyclosporine and tacrolimus (TAC), are the cornerstone of any pediatric immunosuppression protocol. Variable TAC levels are a primary indicator of medication non-adherence, which is common with adolescent and young adult transplant patients [1–4]. The 10-year kidney allograft survival for adolescents ages 12–18 years and young adults 19–24 is the lowest among all age groups, averaging 40.1% for deceased donors and 52.9% for living donor recipient [5].…”

Section: Introductionmentioning

confidence: 99%

Analysis of tacrolimus and creatinine from a single dried blood spot using liquid chromatography tandem mass spectrometry

Koop¹,

Bleyle²,

Munar³

et al. 2013

Journal of Chromatography B

View full text Add to dashboard Cite

Long term therapeutic drug monitoring and assessment of renal function are required in renal transplant recipients on immunosuppressant therapy such as tacrolimus. Dry blood spots (DBS) have been used successfully in the clinic for many years and offers a convenient, simple and non-invasive method for repeated blood tests. We developed and performed a preliminary validation of a method for the analysis of tacrolimus and creatinine from a single DBS using liquid chromatography-tandem mass spectrometric (LC–MS/MS). Tacrolimus and creatinine were extracted from a 6 mm punch with a mixture of methanol/acetonitrile containing ascomycin and deuterated creatinine as internal standards. A 10 μl aliquot of the extract was analyzed directly after dilution for creatinine with normal phase high performance liquid chromatography and multiple reaction monitoring. The remainder of the extract was processed and analyzed for tacrolimus. The lower limit of quantification for tacrolimus was 1 ng/ml with accuracy of 0.34% bias and precision (CV) of 11.1%. The precision ranged from 1.33% to 7.68% and accuracy from −4.44% to 11.6% bias for the intra- and inter-day analysis. The lower limit of quantification of creatinine was 0.01 mg/dL with precision of 7.94%. Accuracy was based on recovery of additional creatinine spiked into whole blood samples and ranged from −2.45% bias at 5 mg/dL to 3.75% bias at 0.5 mg/dL. Intra- and inter-day precision was from 3.48 to 4.11%. The assay was further validated with DBS prepared from pediatric renal transplant recipients. There was excellent correlation between the levels of tacrolimus and creatinine obtained from the clinical laboratory and the DBS method developed. After additional validation, this assay may have a significant impact on compliance with medication intake as well as potentially lowering the cost associated with intravenous blood draws in clinical laboratories.

show abstract

“…Related questions of considerable importance are to what extent a patient needs to adhere to the prescribed treatment to obtain clinical benefits, and at what point nonadherence is likely to result in a clinically meaningful difference in response. This so-called "adherence threshold" is an important yet understudied area of investigation [17]. Yet, since a large number of youth with ADHD start and restart medication, sometimes repeatedly, over the course of several years [18], understanding the adherence threshold will illuminate the extent to which this pattern of behavior is seen as problematic.…”

Section: Defining and Understanding Adherencementioning

confidence: 99%

Improving Medication Adherence in Chronic Pediatric Health Conditions: A Focus on ADHD in Youth

Chacko

Newcorn

Feirsen

et al. 2010

CPD

View full text Add to dashboard Cite

Chronic pediatric health conditions pose a significant challenge for youth, their families and professionals who treat these conditions. Long-term adherence to interventions, including and often-times, pharmacological interventions, is necessary but often problematic. Understanding factors related to poor adherence and intervening to improve adherence is essential in order to maximize long-term outcomes. Attention-deficit/hyperactivity disorder (ADHD) is one such chronic health condition requiring long-term adherence to treatment. The aims of this review are to 1) review the extant literature regarding rates of adherence to medication for youth with ADHD; 2) summarize what is known regarding factors that impede and support greater adherence to medication; 3) introduce the Unified Theory of Behavior Change as a conceptual model that may assist in developing adherence treatment packages to support medication adherence; and 4) describe several potential interventions based on the Unified Theory of Behavior Change that may improve adherence to medication for youth with ADHD. Although pharmacological interventions for youth with ADHD have been evaluated for decades, only more recently has adherence to medication been the subject of interest. However, this literature has exclusively focused on understanding factors related to adherence, with no empirical studies of interventions to improve adherence in youth with ADHD. This paper provides a rationale and research agenda for systematic study of interventions to support medication adherence in youth with ADHD.

show abstract

Evaluating non‐adherence to immunosuppressant medications in pediatric liver transplant recipients

Cited by 90 publications

References 17 publications

Non-Adherence and Graft Failure in Adult Liver Transplant Recipients

Non-Adherence and Graft Failure in Adult Liver Transplant Recipients

Analysis of tacrolimus and creatinine from a single dried blood spot using liquid chromatography tandem mass spectrometry

Improving Medication Adherence in Chronic Pediatric Health Conditions: A Focus on ADHD in Youth

Contact Info

Product

Resources

About