Extended Adherence from HTX-Patients: A Closer Look

Introduction: Nonadherence may cause severe health problems in heart transplant (HTx) recipients. Research Questions: The present study aimed to investigate adherence to prescribed medication and recommended lifestyle habits in post-HTx patients and to assess associations between adherence, quality of life (QOL), and psychological well-being. Design: A questionnaire package was sent to all HTx patients from our clinic (n ¼ 858) to answer questions anonymously on medication adherence, dietary recommendations (avoidance of raw animal products and ice cream), pet keeping (risk of zoonosis), anxiety and depression, QOL, and posttraumatic stress disorders. Results: Of the contacted patients, 524 (61%) responded and 505 fulfilled the inclusion criteria (age !18 years and ability to understand German). Of the study participants, 72.4% reported taking their medications very correctly, 72.2% stated consuming alcohol less often than once a week, 58.3% performed physical exercise at least once a week, one-third reported eating nonrecommended foods, 22.1% stated pet keeping, and 4.3% reported smoking. Adherence to prescribed medication was positively associated with age (P < .001) and mental QOL (P ¼ .015) but was unrelated to eating nonrecommended foods (P > .05). Depressiveness correlated inversely with physical QOL (r ¼ À0.232; P < .01) and mental QOL (r ¼ À0.411; P < .01). Stress disorders and minor stressful events were reported by 7.8% and 46.6%, respectively. Stress disorders correlated inversely with mental QOL (r ¼ À0.282; P < .01) and physical QOL (r ¼ À0.422; P < .01). Discussion: Many HTx patients adhere to prescribed medications and health advice. Nevertheless, nonadherence is a problem, especially in younger HTx patients, indicating the need for a nonadherence crisis intervention program for long-term HTx patients.

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“…To improve adherence, we therefore developed the Specific Active Refinement of heart transplant patients program. 27…”

Section: Resultsmentioning

confidence: 99%

Adherence of Heart Transplant Recipients to Prescribed Medication and Recommended Lifestyle Habits

et al. 2017

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“…The study intervention, entitled SARAH ( S pecific A ctive R efinement of A dherence of H eart Transplanted Patients), was a manualized training program for patients and their relatives that, uniquely, begins training before transplantation. 10 It was developed on the basis of clinical experience to instruct patients on the importance of medication adherence and to address known psychosocial risk factors for nonadherence. It provided 8 preoperative modules of 45–60 minutes, beginning immediately after patients were placed on the high-urgency list for transplantation.…”

Section: Methodsmentioning

confidence: 99%

An Intervention Trial for Strengthening Medical Adherence after Heart Transplantation

Tigges-Limmer

Schmid-Ott

et al. 2022

Prog Transpl

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Introduction In heart transplant recipients, nonadherence is associated with higher risk of morbidity and mortality. Research Question Can a psychoeducational intervention enhance adherence to medical recommendations? Design We randomized 200 patients awaiting heart transplantation on the high urgency wait list to a manualized psychoeducational intervention or standard care. Follow-up continued to three years after transplantation. Primary endpoint was adherence to immunosuppressive medication, assessed at 3, 6, 12, 24, and 36 months posttransplant. Secondary endpoints were barriers to adherence during follow-up and clinical outcomes, including cardiac rejection within the first postoperative year and postoperative 3-year mortality. Results Fifty patients died before or within the first 3 months of transplantation. The primary endpoint was analyzed in 66 patients in the intervention group and 66 in the control group. Both study groups showed almost maximal adherence to immunosuppressive medication throughout follow-up, with no significant time x treatment interaction (P>0.99). Likewise, there was no significant time x treatment interaction ( P=0.41) on barriers to adherence. The percentage of patients with International Society for Heart and Lung Transplantation standard grade 1 and 2 rejection was in the intervention and control groups 82.5% and 78.7%, respectively, and 8.8% and 13.1%, respectively, without significant differences between study groups ( P=0.75). Considering all randomized and transplanted patients in the intervention group (N=85) and control group (N=87), postoperative 3-year mortality was 29.4% and 27.6%, respectively ( P=0.82). Conclusions Adherence to immunosuppressive medication was high, even without a complex, manualized psychoeducational intervention. The intervention had no significant positive impact on cardiac rejection and mortality.

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Extended Adherence from HTX-Patients: A Closer Look

Cited by 2 publications

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Adherence of Heart Transplant Recipients to Prescribed Medication and Recommended Lifestyle Habits

Adherence of Heart Transplant Recipients to Prescribed Medication and Recommended Lifestyle Habits

An Intervention Trial for Strengthening Medical Adherence after Heart Transplantation

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