Quality of life associated with immunosuppressant treatment adherence in liver transplant recipients: A cross-sectional study

Shafiekhani, Mojtaba; Shahabinezhad, Farbod; Tavakoli, Zahra; Tarakmeh, Tahereh; Haem, Elham; Sari, Negar; Nasirabadi, Shohreh; Dehghani, Morteza

doi:10.3389/fphar.2023.1051350

Cited by 4 publications

(1 citation statement)

References 30 publications

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“…Evidence supports that adherence improves health outcomes and quality of life. [1][2][3] Even the World Health Organization (WHO) quoted "increasing the effectiveness of adherence interventions may have a far greater impact on the health of the population than any improvement in specific medical treatments". 4 In kidney transplant recipients, adherence is a key factor for medium-and long-term outcomes.…”

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confidence: 99%

Is Non-Adherence Associated with Adverse Outcomes in Kidney Transplant Recipients? The Role of Non-Adherence as a Risk and Predictor Factor for Graft Loss and Death

Torres-Gutiérrez,

Lozano-Suárez,

Burgos-Camacho

et al. 2023

PPA

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Non-adherence in kidney transplants is diversely defined. Immunosuppression non-adherence (INA) is the most used definition and has been associated with graft loss and acute rejection. But INA assesses only one fraction of adherence. Therefore, we analyzed the association of a holistic non-adherence definition with transplant outcomes and compared its prediction performance with other definitions. Methods: We retrospectively included 739 kidney recipients between 2019 and 2021. We evaluated holistic non-adherence (HNA), suboptimal-immunosuppressor levels (SIL), appointment non-adherence (ANA), procedure non-adherence (PNA) and INA. The main outcomes were graft loss, graft rejection, and mortality. A backward logistic regression was performed estimating adjusted and unadjusted odds ratio (OR) for each outcome. Finally, we compared the non-adherence definitions' prediction for the main outcomes using the area under the curve. Results: HNA was present in 28.7% of patients. Non-adherent patients had an adjusted OR of 2.66 (1.37-5.15) for mortality, 6.44 for graft loss (2.71-16.6), and 2.28 (1.15-4.47) for graft rejection. INA and PNA presented a moderate discrimination for graft loss and HNA and ANA mild-to-moderate discrimination for graft loss and death. Conclusion: Holistic non-adherence was associated with worst outcomes in kidney recipients and had a significant prediction performance for graft loss and mortality.

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Section: Introductionmentioning

confidence: 99%

Is Non-Adherence Associated with Adverse Outcomes in Kidney Transplant Recipients? The Role of Non-Adherence as a Risk and Predictor Factor for Graft Loss and Death

Torres-Gutiérrez,

Lozano-Suárez,

Burgos-Camacho

et al. 2023

PPA

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Immunosuppressive medication adherence and affecting factors in solid organ transplantation patients: a mixed-methods study

Gündüz,

Kiraz,

Küçükkaya

et al. 2024

The European Research Journal

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Objectives: Transplantation is a form of treatment that requires long-term pharmacotherapy. After transplantation, patients may have difficulty adapting to medication use for various reasons, and this may result in rejection. The aim of this study is to determine participants’ medication compliance and the factors affecting it. Methods: The research was conducted with a sequential explanatory mixed method. In the study, quantitative data were collected using the Turkish Immunosuppressive Medication Adherence Scale, and qualitative data were collected using the In-Depth Individual Interview Guide. Quantitative data were analyzed using statistical methods, and qualitative data were examined according to Braun and Clarke's thematic analysis framework. Results: In this study, 62.3% of the participants were male, 37.0% were 50 years old and over, 71.3% lived with their spouse, 54.0% had primary and secondary school education, and 42.0% could not work due to their current health condition. From a clinical perspective, it was determined that 78% of the transplants were kidney transplants, and 41.3% were more than 4 years after transplantation. 74.3% of the transplants were from living donors. The mean score of the immunosuppressive medication compliance scale was determined to be 40.91±4.09. In the qualitative data analysis of the study, factors affecting medication adherence were examined and the themes of "individual factors", "complexity of the regimen" and "social support resources" were obtained. The sub-themes of the individual factors theme are reluctance, hopelessness and addiction; Sub-themes of the complexity of the regimen theme are drug side effects and polypharmacy; The sub-themes of the social support resources theme are loneliness and family pressure. Conclusions: The factors influencing medication adherence among organ transplant recipients have been investigated, revealing that adherence levels vary significantly depending on various factors. These findings underscore the importance of tailored care strategies and individualized support approaches.

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Clinical Outcomes and Quality of Life of Patients Receiving Multi-Solid-Organ Transplants in Childhood Are Excellent: Results From a 20-Year Cohort Study

Paessler,

Maple,

Cortes

et al. 2024

Transpl Int

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Advances in medicine allow children with previously fatal conditions to survive longer and present as transplant candidates; some requiring multiple solid-organ transplants (MSOT). There is limited data on clinical outcomes and no data on quality of life (QoL). In this mixed methods cohort study clinical outcomes from the NHSBT registry were analysed for all patients who received a kidney and one other solid-organ transplant as a child between 2000 and 2021 in the UK. QoL was measured using the PedsQL 3.0 Transplant Module questionnaire. 92 children met the inclusion criteria: heart/heart-lung and kidney (n = 15), liver and kidney (n = 72), pancreas and kidney (n = 4) and multivisceral (n = 1). Results showed excellent patient and graft survival, comparable to single-organ transplants. Allograft survival and rejection were significantly better in patients with combined liver and kidney transplants compared to patients with sequential liver and kidney transplants. QoL was excellent with a mean score of 74%. Key findings included a significant improvement in QoL post-transplant. This is the first study to look at clinical and QoL outcomes in MSOT recipients. The results indicate excellent long-term outcomes. All children born with conditions leading to end-stage disease in multiple solid-organs should be assessed as transplant candidates.

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Quality of life associated with immunosuppressant treatment adherence in liver transplant recipients: A cross-sectional study

Cited by 4 publications

References 30 publications

Is Non-Adherence Associated with Adverse Outcomes in Kidney Transplant Recipients? The Role of Non-Adherence as a Risk and Predictor Factor for Graft Loss and Death

Is Non-Adherence Associated with Adverse Outcomes in Kidney Transplant Recipients? The Role of Non-Adherence as a Risk and Predictor Factor for Graft Loss and Death

Immunosuppressive medication adherence and affecting factors in solid organ transplantation patients: a mixed-methods study

Clinical Outcomes and Quality of Life of Patients Receiving Multi-Solid-Organ Transplants in Childhood Are Excellent: Results From a 20-Year Cohort Study

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