Adherence to immunosuppression in adult heart transplant recipients: A systematic review

Hussain, Tasmeen; Nassetta, Keira; O’Dwyer, Linda; Wilcox, Jane E.; Badawy, Sherif M.

doi:10.1016/j.trre.2021.100651

Cited by 16 publications

(28 citation statements)

References 61 publications

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“…Of note, the lack of standardization for measuring adherence is not an issue unique to pediatric transplant recipients. In the adult literature, there are numerous tools to measure immunosuppression adherence [ 28 ]. The majority of these tools are self-report measures [ 28 ], which have their limitations (including Hawthorne-type effects and social desirability).…”

Section: Discussionmentioning

confidence: 99%

“…In the adult literature, there are numerous tools to measure immunosuppression adherence [ 28 ]. The majority of these tools are self-report measures [ 28 ], which have their limitations (including Hawthorne-type effects and social desirability). While many pediatric studies utilized immunosuppressant drug levels to determine adherence, this was less common in the adult literature [ 28 ].…”

Section: Discussionmentioning

confidence: 99%

“…The majority of these tools are self-report measures [ 28 ], which have their limitations (including Hawthorne-type effects and social desirability). While many pediatric studies utilized immunosuppressant drug levels to determine adherence, this was less common in the adult literature [ 28 ]. It is worth noting that recent efforts led to the development of the PROMIS Medication Adherence Scale (PMAS), which is a widely available, free self-report measure of adherence.…”

Section: Discussionmentioning

confidence: 99%

“…It is also possible that medication nonadherence may lead to emotional distress and physical symptoms, which may negatively impact quality of life and mental health. Adult heart transplant patients also struggle with mental health and socioeconomic comorbidities, as well as engaging with support networks [ 28 ]. When discussing medication adherence, time should be spent addressing a patient’s mental health concerns to identify those that would benefit from psychiatric/psychological intervention.…”

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Adherence to Immunosuppression among Pediatric Heart Transplant Patients

Nassetta

Hussain

Gambetta

et al. 2022

JCDD

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After pediatric heart transplant, commitment to lifelong immunosuppression is crucial to maintaining graft health. However, a review of the current literature surrounding adherence to immunosuppression in pediatric heart transplant patients is lacking. This systematic review aims to summarize the current landscape of adherence to immunosuppression in pediatric heart transplant patients. We conducted searches in PubMed MEDLINE, Embase, CENTRAL register of Controlled Trials (Wiley), and Scopus, from inception to March 2020. Studies were eligible if they outlined an aspect of adherence to immunosuppression and the measurement of adherence was performed with an objective or otherwise validated measure of adherence (e.g., drug levels, adherence questionnaires). The titles/abstracts of 880 articles were reviewed. After initial screening, 106 articles underwent full text review. As such, 14 articles were included in the final review. Baseline adherence estimates varied greatly, with most values between 40% and 70%. Nonadherence to immunosuppression is associated with worse outcomes (rejection, hospitalization, mortality), impaired quality of life, and mental health concerns in pediatric heart transplant patients. As nonadherence to immunosuppression is common and associated with worse outcomes, there is a need for further development and evaluation of interventions in this space.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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A Systematic Review of Adherence to Immunosuppression among Pediatric Heart Transplant Patients

Nassetta

Hussain

Gambetta

et al. 2022

JCDD

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“…A review performed by Hussain et al presented a wide variety of problems influencing adherence to immunosuppression in transplant patients and concluded that there were modifiable factors to address to create improvements [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Neutrophil to Lymphocyte Ratio (NLR) as an Easily Accessible Parameter for Monitoring Tacrolimus Overdose after Heart Transplantation—Experimental Study

et al. 2021

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(1) Background: The combination of candidate selection, immunosuppressive therapy adjustment, and scrutinous monitoring is a cornerstone for optimizing long-term survival after a heart transplant. Neutrophil-to-lymphocyte ratio (NLR) is a simple marker of inflammatory reactions activation and may play a clinical role as a predictive marker in oncological and cardiovascular diseases. The aim of the study was to find simple hematologic indices available from whole blood count to help in immunosuppressive therapy monitoring. (2) Methods: Thirty patients (23 men and 7 women) with a mean age of 43 +/− 13 years who had undergone orthotopic heart transplantation were enrolled into the study. The blood samples for whole blood count and Tacrolimus level were collected during outpatient visits in heart transplant recipients every two months for 18 months after first year post transplantation. (3) Results: There was a significant correlation between Tacrolimus overdose (>15 ng/mL) and NLR (Spearman’s rho 0.99, p < 0,001) and mean platelet volume (Spearman’s rho 0.989, p < 0.001). The ROC analysis for NLR above 3.62 showed predictive properties for Tacrolimus overdose (over 15 ng/mL) (AUC =0.633, p = 0.008) with a sensitivity of 50% and specificity of 83.73%. (4) Conclusions: Our results suggest that NLR above 3.62 may be regarded as a simple indicator of tacrolimus overdose.

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Clinical outcomes of ventricular assist device support by HIV infection status: An STS-INTERMACS analysis

Birk¹,

Baran²,

Campbell³

et al. 2023

The Journal of Heart and Lung Transplantation

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Adherence to immunosuppression in adult heart transplant recipients: A systematic review

Cited by 16 publications

References 61 publications

A Systematic Review of Adherence to Immunosuppression among Pediatric Heart Transplant Patients

A Systematic Review of Adherence to Immunosuppression among Pediatric Heart Transplant Patients

Neutrophil to Lymphocyte Ratio (NLR) as an Easily Accessible Parameter for Monitoring Tacrolimus Overdose after Heart Transplantation—Experimental Study

Clinical outcomes of ventricular assist device support by HIV infection status: An STS-INTERMACS analysis

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