Adherence to immunosuppressive treatment in post-renal transplant patientes: a descriptive-exploratory study

Abstract

To check the adherence to the immunosuppressive treatment of post-renal transplant patients. Method: This is a quantitative, transversal, descriptive-exploratory study performed using 50 patients in the Brazilian state of Santa Catarina. The study involved a semistructured interview based on the "Measurement Test of Adherence to Treatments". Results: It was observed that 76% of the patients were considered to be non-adherent to the immunosuppressive treatment; in 62% of the cases it was unintentional behavior; 2% of the cases mentioned lack of motivation to continue treatment; 44% of the cases ingested from 11 to 15 pills/day. The complications reported were hypertension, diabetes and graft rejection. Discussion: Besides the non-adherence, patients demonstrated understanding and motivation regarding the medication. The excessive umber of drugs ingested on a daily basis influenced the adherence to the treatment. There were two chronic rejections, one of which presented a connection to non-adherence to the immunosuppressive treatment. Conclusion: The number of medications contributed to non-adherence.

The Effect of Immunosuppressant Therapy Adherence on the Comfort of Liver Transplant Recipients

“…Other factors interfering with adherence to immunosuppressive therapy include lack of sufficient social support for liver transplant patients, economic difficulties, and the idea that treatment is not effective (Gorevski, 2013; Madran, Karayurt, Spıyev, & Chısholm-Burns, 2016; Zhu, Zhou, Zhang, Zhang, & Lin, 2017). Along with the problem of adherence to therapy, other factors such as lowered levels of physical energy, changes in the body, anxiety, fear of death, and fear of tissue rejection or infection may negatively affect patient comfort (Kung et al, 2017; Maissiat et al, 2013; Ortega, 2015).…”

“…Kolcaba argues that comfort is the product of the whole patient in the physical, psychospiritual, environmental, and sociocultural sense structured around providing the individual help for these needs, but also promotes inner peace and coping with problems (Boudiab & Kolcaba, 2015; Pinto, Caldeira, Martins, & Rodgers, 2017). Nurses have a very important part to play in order to achieve this result, especially in helping liver transplant patients with their struggle to adhere to immunosuppressive therapy and improve their comfort levels (Maissiat et al, 2013; Nural & Alkan, 2018). Familial, social, and psychological support nurses provide during the adaptation process is among the interventions that bring comfort to individuals (Karabulut & Yaman, 2012; Maissiat et al, 2013; Ortega, 2015).…”

“…Nurses have a very important part to play in order to achieve this result, especially in helping liver transplant patients with their struggle to adhere to immunosuppressive therapy and improve their comfort levels (Maissiat et al, 2013; Nural & Alkan, 2018). Familial, social, and psychological support nurses provide during the adaptation process is among the interventions that bring comfort to individuals (Karabulut & Yaman, 2012; Maissiat et al, 2013; Ortega, 2015).…”

“…The most important factor is the immunosuppressive treatment to be administered (Promraj et al, 2016). Immunosuppressive therapy is a process that the patient must adhere to on a lifelong basis following transplantation and entails the nonspecific suppression of the immune system against foreign structures (Lee, Chu, Oh, & Huh, 2015; Maissiat, Marin, & Fuzinatto, 2013). Inadequate immunosuppressive therapy causes organ rejection, whereas an overdose may lead to infections or malignancy to affect a patient's life (Ortega, 2015).…”

Adesão í terapia imunossupressora de transplantados renais de um hospital universitário

“…Como toda terapêutica de doença crônica, o transplante necessita de boa adesão ao tratamento e uso dos imunossupressores, para que se obtenha o sucesso da manutenção da saúde e do enxerto a longo prazo (7) . Segundo a Organização Mundial de Saúde (OMS), a adesão ao tratamento (8) traz em seu conceito a capacidade do indi-víduo em agir conforme as orientações do profissional de saúde quanto à tomada dos medicamentos, estilo de vida e nutrição adequados.…”