Prospective Randomized Trial Investigating the Influence of Pharmaceutical Care on the Intra-Individual Variability of Tacrolimus Concentrations Early After Kidney Transplant: Erratum

Bessa, Adrieli; Felipe, Cláudia Rosso; Hannun, Pedro; Sayuri, Priscila; Felix, M.; Ruppel, Priscila; Ferreira, Alexandra; Cristelli, Marina Pontello; Viana, Laila Almeida; Mansur, Juliana; Basso, Geovana; Aguiar, Wilson; Tedesco‐Silva, Hélio; Medina-Pestana, J.O.

doi:10.1097/ftd.0000000000000299

Cited by 25 publications

(24 citation statements)

References 35 publications

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“…A total of eight studies were included encompassing 546 patients (ranging from 15 to 130 patients per study) ( table 1 ). 25–32 Six of the included studies were randomized trials, and the other two studies were prospective. One study reported results for underage population, others recruited patients with the mean age ≥40 years, with a greater percentage of the population being male.…”

Section: Resultsmentioning

confidence: 99%

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

Zhu

Zhou

Zhang

et al. 2017

Journal of Investigative Medicine

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Immunosuppressive treatment regimens are complex and require ongoing self-management. Medication adherence can be difficult to achieve for several reasons. The current meta-analysis and systematic review investigated whether adherence interventions improved immunosuppressive treatment adherence in kidney transplant recipients. Medline, Cochrane, EMBASE, and Google Scholar were searched until October 17, 2016 using the following search terms: kidney transplantation, compliance, adherence, and immunosuppressive therapy. Randomized controlled trials and two-arm prospective, retrospective, and cohort studies were included. The primary outcomes were adherence rate and adherence score. Eight studies were included with a total for 546 patients. Among participants receiving intervention, the adherence rate was significantly higher than the control group (pooled OR=2.366, 95% CI 1.222 to 4.578, p=0.011). Participants in the intervention group had greater adherence scores than those in the control group (pooled standardized difference in means =1.706, 95% CI 0.346 to 3.065, p=0.014). Sensitivity analysis indicated that findings for adherence rate were robust. However, for adherence score, the significance of the association disappeared after removing one of the studies indicating the findings may have been overly influenced by this one study. Intervention programs designed to increase immunosuppressive adherence in patients with kidney transplant improve treatment adherence.

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Section: Resultsmentioning

confidence: 99%

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

Zhu

Zhou

Zhang

et al. 2017

Journal of Investigative Medicine

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“…Similar to work on prevalence and risk factors for non-adherence, posttransplant adherence intervention research in kidney recipients is dominated by a focus on immunosuppressant medication-taking. Table 2 provides details on nine RCTs for immunosuppressant non-adherence conducted in the past 5 years [9••, 61–63, 64•, 65, 66, 67•, 68•]. As shown, the interventions fall into three major categories: educational and counseling interventions, interventions relying on electronic health (e-health) approaches, and a dosing/medication formulation change intervention.…”

Section: Interventions Focused On Non-adherence To the Medical Regimenmentioning

confidence: 99%

“…Several of the trials in Table 2 also examined clinical outcomes, including infections [63], graft function [62, 68•], graft rejection and loss [63, 68•], and death [62, 63, 64•]. Some considered indirect measures of health outcome, including rehospitalizations [61, 63, 68•], and emergency and outpatient visits [61, 68•]. The adherence interventions reduced rehospitalization risk in two studies [61, 68•].…”

Section: Interventions Focused On Non-adherence To the Medical Regimenmentioning

confidence: 99%

Posttransplant Medical Adherence: What Have We Learned and Can We Do Better?

et al. 2018

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Purpose of review Non-adherence to the medical regimen after kidney transplantation can contribute to poor clinical outcomes, and strategies to maximize adherence are sought by care providers and patients alike. We assessed recent evidence on prevalence, risk factors, and clinical outcomes associated with non-adherence to the medical regimen after kidney transplantation. We summarized recent clinical trials testing interventions to improve adherence and generated recommendations for future research and clinical practice. Recent findings A large evidence base documents rates of non-adherence to each of the multiple components of the regimen, including medication-taking, lifestyle activities, clinical care requirements, and substance use restrictions. Some risk factors for non-adherence are well known but the full range of risk factors remains unclear. Non-adherence to immunosuppressants and to other components of the regimen increases morbidity and mortality risks. Recent interventions, including education and counseling; electronic health strategies; and medication dose modifications, show promise for reducing immunosuppressant non-adherence. However, most of these interventions would be difficult to deploy in everyday clinical practice. Systematic dissemination of efficacious interventions into clinical practice has not been undertaken. Summary Rates and risk factors for non-adherence to the medical regimen have been examined and there is evidence that non-adherence may be ameliorated by a range of interventions. Although gaps in the evidence base remain, it would be timely to devote greater efforts to dissemination of findings. Thus, efforts are needed to assist transplant programs in using existing evidence to better identify patients who are non-adherent and to design and implement strategies to reduce or prevent non-adherence.

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“…Brazil, the most populous Country of South America, accounts for more than half of the publications, followed by Argentina, Colombia, and Chile ( Table 1). TDM of immunosuppressants was subject of relevant studies, including a prospective randomized trial on tacrolimus therapy in kidney transplant [4], from the group from the "Hospital do Rim", a world reference center in kidney transplants located in São Paulo, Brazil, and a two years follow up study from the Argentinean "J.P. Garrahan Hospital" on pharmacogenetic and tacrolimus in pediatric liver patients [5]. Pharmacogenetic was also explored in several Brazilian studies.…”

Section: State Of Affairs In South Americamentioning

confidence: 99%

Therapeutic drug monitoring in developing nations: assessing the current state of affairs in South America

Antunes

Linden

Schaiquevich

2021

Expert Opinion on Drug Metabolism & Toxicology

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Prospective Randomized Trial Investigating the Influence of Pharmaceutical Care on the Intra-Individual Variability of Tacrolimus Concentrations Early After Kidney Transplant: Erratum

Abstract: Universal PhC in addition to standard nurse staff instruction was not associated with reduced intra-individual variability of dose-corrected whole blood TAC trough concentrations or improved adherence.

Cited by 25 publications

References 35 publications

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

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

Posttransplant Medical Adherence: What Have We Learned and Can We Do Better?

Therapeutic drug monitoring in developing nations: assessing the current state of affairs in South America

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