Self-Management in Liver Transplant Recipients

Ko, Dami; Muehrer, Rebecca J.; Bratzke, Lisa C.

doi:10.1177/1526924818765814

Cited by 19 publications

(32 citation statements)

References 48 publications

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“…Self-reported nonadherence to posttransplant medication regimens ranges from 8% to 66%. 16 Lower income, recent transplantation, the number of medications prescribed, and lower health literacy were associated with lower medication treatment knowledge scores. 17 Perez et al 18 advocated for medication teaching that includes dose, action, frequency, and adverse effects.…”

Section: Introductionmentioning

confidence: 95%

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission

et al. 2020

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Introduction: Early hospital readmission following liver transplantation is associated with lower survival and worse long-term graft function. Language, cultural practices, and health literacy influence patient understanding of posttransplant care education. Complex medication regimes, changes in metabolism and nutrition absorption, and infection/rejection further complicate the prevention of readmission. Purpose: The purpose of this study was to compare the 30-day readmissions of single-organ liver transplant recipients for 1-year prior and 1-year following the implementation of nurse-led education. The study examined the demographics, clinical characteristics, and 30-day readmissions of 35 liver transplant recipients who participated in the newly designed nurse-led education and 51 liver transplant recipients who experienced the prior post-liver transplant education. Design: A single-center, correlational study with a convenience sample was conducted at a Hispanic-serving South Texas hospital. The new education intervention maintained the standard education and added twice-daily mutual patient-focused goal setting between the nurse and the recipient that aligned with readiness for discharge activities/goals, structured education using abbreviated handouts written at a second-grade level available in both English and Spanish, and the use of repetition through multimodal methods. Results: The odds for 30-day readmissions the year prior to the nurse-led patient education intervention were 2.088 times greater than the year following the implementation. Thirty-day readmissions were reduced by 16.3% from the 2017 cohort to the 2018 cohort. Discussion: Understanding unique risk factors facilitates structured patient education which can be individualized to the patient and caregiver including collaborative nurse–patient goals.

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Section: Introductionmentioning

confidence: 95%

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission

et al. 2020

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“…Self-management: the recipient must, of course, share responsibility with the health care professionals. A recent study [ 43 ] identified areas of self-management including medication nonadherence, alcohol recidivism and health maintenance. Reported rates of medication nonadherence ranged from 8% to 66%.…”

Section: Follow-up Of Transplant Recipientsmentioning

confidence: 99%

Follow-up of liver transplant recipients

Neuberger

2020

Best Practice & Research Clinical Gastroenterology

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The number of surviving liver allograft recipients is increasing almost exponentially. The quality and length of life is increasing but most recipients have reduced survival and quality of life compared with healthy matched individuals. Causes of premature death include cardio and cerebrovascular disease, renal failure, graft failure, de novo malignancy and recurrent disease. Follow-up is needed lifelong to ensure graft and patient health and ensure that complications are recognised and treated early. Immunosuppression is kept to the appropriate minimum and prophylactic interventions are given early, such as use of statins and tight control of blood pressure and blood sugar. Recipients will require life-long follow-up, and this is placing an increasing burden on transplant units. Follow-up is best done by close collaboration between the Liver Transplant Unit, the local hospital and primary care team. Involvement of other health care practitioners, such as recipient coordinators, pharmacists, dermatologists and addiction specialists may improve outcomes. Key to successful follow-up are agreed protocols and good communication between the recipients and all relevant health care providers. Use of IT allows for better communication and will support use of video and telephone consultations in selected instances. The most appropriate follow-up will depend on many factors, including logistic and geographic issues, local experience. The provision of well-funded and supported registries at local, national and international levels will allow for improvements in management.

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“… 37 Concerning other types of transplanted organs we could solely identify a study by Beckmann et al 38 that adapted the Schäfer-Keller model for liver transplant recipients and one narrative review, also including recipients of liver transplant, which aimed to synthesise evidence concerning self-management on a conceptual level. 22 A comprehensive overview covering the concept of self-management across all SOTx population could not be identified. As outlined above, conceptualisations of self-management exist either on a superordinate or macro level in so far as tailoring to population groups, based on research on chronic diseases or sporadically on a microlevel specific for kidney and liver transplant patients.…”

Section: Introductionmentioning

confidence: 99%

“…Previous research suggests that some SOTx recipients struggle with the implementation of necessary self-management tasks and lifestyle changes11 17–22 and therefore need self-management support 11 17 23–25. Literature review findings suggest that the majority of self-management support interventions mainly focus on treatment and medication adherence after SOTx 26–32.…”

Section: Introductionmentioning

confidence: 99%

Self-management in adults after solid-organ transplantation: a scoping review protocol

et al. 2023

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IntroductionAfter solid-organ transplantation (SOTx), recipients must adhere to a lifelong medical regimen, change their lifestyle and cope with physiological and psychosocial challenges. This requires active participation in their care and self-management abilities. The concept of self-management after SOTx has only been described regarding specific organs and focused on adherence to medical treatment. A comprehensive conceptualisation of self-management entailing all solid organs and beyond medical aspects does not exist. This might lead to unmet self-management support needs of SOTx recipients and hinder a more holistic and integrative approach in self-management support. Therefore, a better understanding of the concept of self-management after SOTx is needed to facilitate a comprehensive evidence base for healthcare providers and researchers. The purpose of this scoping review is to explore existing evidence on self-management in adults after SOTx.Methods and analysisTo identify relevant evidence, six electronic databases and three study registers will be searched, supplemented by handsearches, reference checking and expert recommendations. Screening and selection of available evidence will be carried out in a two-step process by two independent reviewers. International evidence published in English or German reporting on adults after heart, lung, liver, pancreas, kidney or small bowel transplantation will be considered. To meet inclusion criteria, articles have to focus on either: self-management, self-management support or recipients’ or healthcare providers’ perspectives of challenges and needs potentially addressable by self-management. Data extraction will be performed by two reviewers independently using a structured form. Data will be analysed descriptively and using content analysis procedures. Findings will be summarised narratively and presented in tabular format.Ethics and disseminationThe consultation and approval of an ethics committee is not required for this scoping review. Findings of the scoping review will be published in a peer-reviewed open-access journal and presented at conferences.

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Self-Management in Liver Transplant Recipients

Abstract: Self-management studies in liver recipients have been narrowly focused on medication nonadherence and alcohol recidivism. To improve self-management in recipients, self-management beyond medication nonadherence and alcohol recidivism should be comprehensively examined.

Cited by 19 publications

References 48 publications

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission

Relationship of Nurse-Led Education Interventions to Liver Transplant Early Readmission

Follow-up of liver transplant recipients

Self-management in adults after solid-organ transplantation: a scoping review protocol

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