Prevalence and Modifiable Determinants of Non-Adherence in Adult Kidney Transplant Recipients in a German Sample

Reber, Sandra; Morawa, Eva; Stößel, Lisa; Jank, Sabine; Vitinius, Frank; Eckardt, Kai‐Uwe; Erim, Yeşim

doi:10.13109/zptm.2016.62.3.270

Cited by 14 publications

(21 citation statements)

References 33 publications

(36 reference statements)

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“…In a meta-analysis, the chances of graft failure were seven times higher in non-adherent patients compared to adherent patients (23) and a study that used BAASIS® to evaluate 74 patients found 14.3% nonadherence. (10) However, the general score for nonadherence found would be higher than cited, with a score similar to results of a Brazilian randomized study that used an education intervention and found adherence of 46.4% in the control group and 14.5% in the intervention group (p=0.001). (18) A prospective cohort study with 1,505 patients in which 924 (61.4%) underwent KTP showed that non-adherence increased continually from six months until three years of follow-up; this finding supports the early adoption of measures supporting adherence to immunosuppressive therapy.…”

Section: Discussionsupporting

confidence: 76%

“…Sociodemographic variables showed a higher score for adherence among married recipients (94.8%) than among single (80.4%) or divorced (64.3%) recipients and autonomous professionals (76.9%). Although the influence of the existence of a conjugal partner is not conclusive in some publications, a recent study (10) showed that being separated or divorced was a factor associated with nonadherence.…”

Section: Discussionmentioning

confidence: 99%

“…(6) According to estimates for developed countries, 50% of patients with non-communicable chronic diseases do not follow up with proposed treatment, with a negative impact on clinical evolution. (6)(7)(8)(9) In transplantation, we estimate that the rate of nonadherence ranges from 2% to 7%, with an annual mean of around 35.6%; (5,10) non-adherence can result in graft rejection or failure, consequently increasing the cost of treatment and even leading to death. (6,11) The risk for death or recipient's return to dialysis after graft failure is higher compared with those on the waiting list for dialysis.…”

Section: Introductionmentioning

confidence: 99%

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Mensuração da adesão aos medicamentos imunossupressores em receptores de transplante renal

et al. 2018

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Objective: To measure adherence of renal transplant recipients to immunosuppressive drugs by using the Basel Assessment of Adherence with immunosuppressive medication Scale (BAASIS®) and to describe sociodemographic characteristics and clinical factors in relation to immunosuppressive drugs and creatinine levels. Methods: This retrospective, cross-sectional study was carried out from 2014 to 2015 in the post-transplantation ambulatory unit of the Kidney Hospital and Universidade Federal de São Paulo (UNIFESP). Results: Of the 181 participants, 53.6% were men; recipients ages ranged from 18 to 74 years. Systemic arterial hypertension was the initial diagnosis of chronic renal failure in 38.7% of recipients. About 95% reported that they never forgot to take several consecutive doses of the medicine, 58.6% of recipients reported total adherence to the immunosuppressive drugs, and 41.4% did not adhere to one or more of the four assessed situations. No signifi cant correlation was found between of creatinine levels and total score and by BAASIS® items. Conclusion: A high rate of patients not adherent to the immunosuppressive treatment was identifi ed (41.4%).There was no signifi cant correlation between creatinine level and receptor age at time of KTP, time after KTP, immunosuppressive separation time and total score and scores of individual BAASIS® items. This study showed that black, male recipients without a family support network, obese and autonomous are more likely not to adhere to immunosuppressive therapy. The evaluation of renal transplant recipient adhesion should be considered during all phases of the nursing process actions that make up the therapeutic plan after renal transplantation. ResumoObjetivo: Mensurar a adesão aos medicamentos imunossupressores em receptores de transplante renal, utilizando a Basel Assessment of Adherence with Immunosuppressive Medication Scale -BAASIS ® e descrever as características sociodemográfi cas, os fatores clínicos em relação aos imunossupressores e os níveis de creatinina. Métodos: Estudo prospectivo, transversal, realizado no período de 2014 a 2015, no Ambulatório Pós-Transplante do Hospital do Rim (complexo hospitalar da Universidade Federal de São Paulo (UNIFESP)). Resultados: Dos 181 participantes, 53,6% eram homens e a idade dos receptores variou de 18 a 74 anos. A Hipertensão Arterial Sistêmica foi o diagnóstico inicial de Insufi ciência Renal Crônica em 38,7% dos receptores. Aproximadamente 95% dos receptores relataram que nunca se esqueceram de tomar o medicamento; 58,6% dos pacientes relataram ter aderido totalmente aos imunossupressores e 41,4% não aderiram a uma ou mais das quatro situações avaliadas pelos itens da BAASIS ® . Não foi encontrada correlação signifi cativa pelos itens da BAASIS ® entre os níveis de creatinina e o escore total. Conclusão: Foi identifi cado um alto índice de pacientes que não aderiram ao tratamento imunossupressor (41,4%). Não houve correlação signifi cativa entre o nível de creatinina e a idade do receptor no momento do TxR, bem c...

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Mensuração da adesão aos medicamentos imunossupressores em receptores de transplante renal

et al. 2018

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“…This global improvement in graft failure and survival rates is most likely due to several factors, including either technological and surgical technique advancements or improvement in medical management and immunosuppressive therapy -it may not be necessarily due to improved medication adherence. (28)(29)(30)(31)(32)(33) Treatment for management of grafts consists of a combination of immunosuppressive agents with different mechanisms of action. This strategy minimizes morbidity and mortality individually associated to each immunosuppressive agent class, maximizing global treatment efficacy.…”

Section: Discussionmentioning

confidence: 99%

Mensuração da não-adesão aos medicamentos imunossupressores em receptores de transplante de fígado

et al. 2019

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Objective: Assessing the level of non-adherence to immunosuppressive therapy in a sample of liver transplantation recipients using the Basel Assessment of Adherence with Immunosuppressive Medication Scale; correlating socio-demographic features and clinical factors to medication non-adherence. Methods: This cross-sectional epidemiological study was conducted between March 2016 and March 2018 at the outpatient service for liver transplantations of the Federal University of São Paulo. Results: Forty-nine patients were assessed. The level of medication non-adherence after liver transplantation was 49%. It was directly correlated to the use of mycophenolic acid (p=0.007) and to multiple daily dosing of immunosuppressant medication (p=0.004). No statistically signifi cant correlations were found between non-adherence to immunosuppressive therapy, socio-demographic features, and the remaining clinical variables assessed.Conclusion: This study shows that nearly half of all patients are not compliant with immunosuppressive therapy after liver transplantation. Given poor liver transplantation outcomes are intimately related to adherence failure, nurses need to assess this behavior in outpatient follow-up of liver transplantation recipients. ResumoObjetivo: Avaliar os níveis de não-adesão à terapia imunossupressora em uma amostra de receptores de transplante de fígado utilizando a Basel Assessment of Adherence with Immunosuppressive Medication Scale; correlacionar as características sociodemográfi cas e os fatores clínicos à não-adesão medicamentosa. Métodos: Estudo epidemiológico e transversal, realizado entre março 2016 e março 2018 no ambulatório de transplante de fígado da Universidade Federal de São Paulo. Resultados: Foram avaliados 49 pacientes. O nível de não-adesão medicamentosa no transplante de fígado foi de 49% e esteve diretamente relacionado ao uso do ácido micofenólico (p=0,007) e à administração de múltiplas doses de imunossupressores diariamente (p=0,004). Não foram encontradas correlações estatisticamente signifi cativas entre a não-adesão à terapia imunossupressora e as características sociodemográfi cas e demais variáveis clínicas analisadas. Conclusão: Este estudo mostrou que quase a metade dos pacientes deixaram de aderir à terapia imunossupressora no pós transplante de fígado. Uma vez que os desfechos desfavoráveis no transplante estão intimamente relacionados à falhas na adesão, é importante os enfermeiros avaliarem esse comportamento durante o seguimento ambulatorial dos receptores de transplante de fígado. ResumenObjetivo: Analizar los niveles de no adhesión a la terapia inmunosupresora en una muestra de receptores de trasplante de hígado utilizando la Basel Assessment of Adherence with Immunosuppressive Medication Scale y correlacionar las características sociodemográfi cas y los factores clínicos con la no adhesión a los medicamentos. Métodos: Estudio epidemiológico y transversal realizado entre marzo de 2016 y marzo de 2018 en los consultorios externos de trasplante de hígado de la Universidad ...

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“…Verglichen mit anderen Transplantationspatienten ist die Medikamenten-Non-Adhärenz bei Nierenempfängern am häufigs-ten, gefolgt von Herz-und Lebertransplantierten (Dew et al 2007). Aktuelle Studien fanden bei nierentransplantierten Patienten in verschiedenen deutschen Transplantationszentren selbstberichtete Non-Adhärenz-Raten von 24 % (Reber et al 2016) bis 37 % (Pabst et al 2015). Denhaerynck et al (2009) kommen bei einem systematischen Überblick zu dem Ergebnis, dass die selbsteingeschätzte Non-Adhärenz der Nierentransplantationspatienten bei 28 % liegt und 20 % der späten akuten Abstoßungsreaktionen sowie 16 % der Transplantatverluste auf dieses problematische Gesundheitsverhalten zurückzuführen sind.…”

Section: Einleitung Und Theoretischer Hintergrund Des Behandlungsmanualsunclassified

Manualisierte Psychotherapie zur Optimierung der Immunsuppressiva-Adhärenz bei Patienten nach Nierentransplantation: Ergebnisse einer Machbarkeitsstudie

Panyi

Erim

2017

Zeitschrift für Psychosomatische Medizin und Psychotherapie

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Summary Manualized psychotherapy for the optimization of immunosuppressant adherence following kidney transplantation: Results of a feasibility studyObjectives: Adherence can be defined as the extent to which patients follow the instructions for prescribed treatments. Up to 37 % of renal transplant recipients are classified as nonadherent to immunosuppressant medication. Nonadherence, however, is significantly correlated with transplant rejection and loss. The objective of this manual is to optimize adherence to immunosuppressant medication, to improve health literacy, and to raise quality of life among renal transplant recipients. Methods: This article introduces a therapeutic manual and shows the results of a feasibility study. Results: Seven patients were recruited for the feasibility study. Acceptance of the participating patients was clear, and there was no treatment discontinuation. All planned contents could be discussed. In addition to the side effects of immunosuppressants, social support was also discussed as an important topic. Conclusions:The intervention can be implemented following kidney transplantation as a regular and stable offer together with the available resources of nephrological and psychosomatic regular care facilities. It is thus easily transferable into the services of transplant centers.

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Prevalence and Modifiable Determinants of Non-Adherence in Adult Kidney Transplant Recipients in a German Sample

Cited by 14 publications

References 33 publications

Mensuração da adesão aos medicamentos imunossupressores em receptores de transplante renal

Mensuração da adesão aos medicamentos imunossupressores em receptores de transplante renal

Mensuração da não-adesão aos medicamentos imunossupressores em receptores de transplante de fígado

Manualisierte Psychotherapie zur Optimierung der Immunsuppressiva-Adhärenz bei Patienten nach Nierentransplantation: Ergebnisse einer Machbarkeitsstudie

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