Describing the evolution of medication nonadherence from pretransplant until 3 years post-transplant and determining pretransplant medication nonadherence as risk factor for post-transplant nonadherence to immunosuppressives: The Swiss Transplant Cohort S

Geest, Sabina De; Burkhalter, Hanna; Bogert, Laura; Berben, Lut; Glass, Tracy R.; Denhaerynck, Kris

doi:10.1111/tri.12312

Cited by 115 publications

(96 citation statements)

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“…Em receptores de órgãos sólidos a não adesão pode aumentar com o passar do tempo após o transplante [22,23]. Ao contrário disso, neste estudo não houve diferença significativa quando relacionado o tempo após o transplante com a adesão.…”

Section: Discussionunclassified

Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

Rocha

Figueiredo

Canabarro

et al. 2017

Sci Med

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Este artigo está licenciado sob forma de uma licença Creative Commons Atribuição 4.0 Internacional, que permite uso irrestrito, distribuição e reprodução em qualquer meio, desde que a publicação original seja corretamente citada. ABSTRACT AIMS: To evaluate the characteristics and risk factors related to the adherence to immunosuppressive treatment of renal transplant patients using the self-report method by means of the Basel Assessment of Adherence Scale for Immunosuppressives (BAASIS). METHODS: A prospective cohort study with a quantitative approach was performed at the Nephrology and Transplantation Service of São Lucas Hospital of the Pontifical Catholic University of Rio Grande do Sul, with patients older than 18 years, transplanted from kidneys from deceased or living donors, with a minimum transplant time of three months and a maximum of 12 months. The BAASIS instrument was applied to evaluate adhesion. For statistical analysis, Fisher exact test (Monte Carlo simulation) was used to verify the association between the categorical variables, Student t test for independent sample means and Mann Whitney test in the variables without normality. A p<0.05 was adopted for the results to be considered significant. RESULTS: The sample consisted of 59 patients, 57.6% of whom were male, 79.7% were white, the mean age was 45.8 years, 57.6% had elementary school and 72.9% were catholic. Hemodialysis was the most used method, in 86.4% of patients before transplantation, and the mean time in the waiting list was 19.5 months. After transplantation, the mean time of hospitalization was 17.2 days. The assessment of adherence by BAASIS characterized 83% of patients as non-adherent. The main fact considered as non-adherence was to take the immunosuppressive drugs with more than two hours difference from the prescribed time, at least once a week, in the last four weeks. There was no significant difference when the statistical analysis was performed to compare the adhesion rate among the various categories of the demographic and clinical variables of the patients. CONCLUSIONS: A high rate of patients not adherent to the immunosuppressive treatment was identified, and the change in the schedule of immunosuppressants was the main fact that characterized this behavior. A shorter waiting time in the transplant queue was associated with non-adherence. The other variables, demographic and clinical, were not associated to the classification of adherent or non-adherent.

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Section: Discussionunclassified

Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

Rocha

Figueiredo

Canabarro

et al. 2017

Sci Med

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“…68 This finding was supported by a larger prospective nationwide cohort study of 1505 renal, liver, lung and heart transplant patients (OR, 3.10; 95% CI, 2.29-4.21). 66 Pretransplant self-reported nonadherence has also been found to be a predictor of acute rejection (OR, 4.4; 95% CI, 1.18-16.16). 68 The large impact that nonadherence has on treatment effectiveness is reflected in poor patient health outcomes, and increased healthcare costs.…”

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confidence: 99%

“…66 A prospective study of 141 lung, heart, and liver transplant patients showed that pretransplant nonadherence was a predictor of poor adherence posttransplant (OR, 7.9; 95% CI, 2. 35-26.8).…”

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confidence: 99%

“…66 A 2006 retrospective audit of the Scottish Liver Transplant Unit's database estimated nonadherence to be responsible for 1 in 10 deaths in liver transplant recipients.…”

mentioning

confidence: 99%

“…65 Most importantly, nonadherence negatively impacted on graft and patient survival after liver transplantation. 66 A 2006 retrospective audit of the Scottish Liver Transplant Unit's database estimated nonadherence to be responsible for 1 in 10 deaths in liver transplant recipients. 67 A meta-analysis by Dew et al 62 demonstrated the rate of nonadherence to have been more common in kidney transplant patients compared to recipients of other solid organs, including liver, heart and lung, with a rate of 36 cases per 100 patients per year in the kidney group.…”

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confidence: 99%

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Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

et al. 2017

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Short-term patient and graft outcomes continue to improve after kidney and liver transplantation, with 1-year survival rates over 80%; however, improving longer-term outcomes remains a challenge. Improving the function of grafts and health of recipients would not only enhance quality and length of life, but would also reduce the need for retransplantation, and thus increase the number of organs available for transplant. The clinical transplant community needs to identify and manage those patient modifiable factors, to decrease the risk of graft failure, and improve longer-term outcomes. COMMIT was formed in 2015 and is composed of 20 leading kidney and liver transplant specialists from 9 countries across Europe. The group's remit is to provide expert guidance for the long-term management of kidney and liver transplant patients, with the aim of improving outcomes by minimizing modifiable risks associated with poor graft and patient survival posttransplant. The objective of this supplement is to provide specific, practical recommendations, through the discussion of current evidence and best practice, for the management of modifiable risks in those kidney and liver transplant patients who have survived the first postoperative year. In addition, the provision of a checklist increases the clinical utility and accessibility of these recommendations, by offering a systematic and efficient way to implement screening and monitoring of modifiable risks in the clinical setting. 12 Department of Gastroenterology and Hepatology, Erasmus MC, University Hospital Rotterdam, the Netherlands. 13 Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Belgium.14 Abdominal Transplant Surgery, Microbiology and Immunology Department, University Hospitals KU Leuven, Belgium. 15 Department of Hepatology and Liver Transplantation, Reina Sofía University Hospital, IMIBIC, CIBERehd, Spain. www.transplantjournal.com S1 S olid organ transplantation has evolved from an experimental procedure to an established treatment option for many types of end-stage organ failure. Both patient and graft outcomes are continuing to improve, and 1-year patient and graft survival currently exceed 80%.1,2 However, survival rates gradually decline over the long term. In kidney transplant, 5-and 10-year graft survival rates in Europe are 77% and 56%, and for liver transplant, 64% and 54% (Figures 1 and 2). 3,4 Although most European countries have seen an increase in both living and deceased donation, transplantation is not available to all who would benefit from the procedure, and there is considerable morbidity and mortality for those listed for transplant.6 Therefore, maximizing long-term graft survival and reducing the need for retransplantation is paramount, not only in improving outcomes for the recipients but also for those awaiting a graft. The improvement in outcomes is predominantly due to reduction in (Transplantation. 2017;101:S1-S41). The authors were approached by Astellas to discuss the practical implementation o...

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Medication nonadherence monitoring and management in adult kidney transplantation: A survey of practices and perceptions at US‐based transplant programs

Patel¹,

Hofmeyer

Moore

et al. 2021

J Am Coll Clin Pharm

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Introduction: Medication nonadherence is a predominant contributor to graft loss, however little is known about currently utilized strategies by transplant centers to monitor or manage this issue.Objective: Utilizing standard surveying and analysis techniques, assess health care professionals' (HCPs) perceptions of the scope and scale of medication nonadherence and strategies used to manage this issue at US-based transplant centers.

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Describing the evolution of medication nonadherence from pretransplant until 3 years post-transplant and determining pretransplant medication nonadherence as risk factor for post-transplant nonadherence to immunosuppressives: The Swiss Transplant Cohort S

Cited by 115 publications

References 36 publications

Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

Avaliação da adesão à terapia imunossupressora por autorrelato de pacientes submetidos ao transplante renal

Practical Recommendations for Long-term Management of Modifiable Risks in Kidney and Liver Transplant Recipients

Medication nonadherence monitoring and management in adult kidney transplantation: A survey of practices and perceptions at US‐based transplant programs

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