Immunsuppressiva-Adhärenz nach Transplantation

Nöhre, Mariel; Erim, Yeşim; Vitinius, Frank; Klewitz, Felix; Schiffer, Mario; Zwaan, Martina de

doi:10.1055/s-0044-100404

Cited by 4 publications

(5 citation statements)

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“…About 40% of kidney transplant recipients are interested in a support group ( 11 ). There is first evidence that adherence after solid-organ transplantation can be improved by psychosocial interventions, such as educational, behavioral, and counseling interventions ( 12 – 18 ). Psychological factors, which might promote onset and maintenance of immunosuppressant medication adherence, can be objectives of psychotherapeutic interventions.…”

Section: Introductionmentioning

confidence: 99%

Psychosocial Variables Associated with Immunosuppressive Medication Non-Adherence after Renal Transplantation

et al. 2018

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IntroductionNon-adherence to immunosuppressive medication is regarded as an important factor for graft rejection and loss after successful renal transplantation. Yet, results on prevalence and relationship with psychosocial parameters are heterogeneous. The main aim of this study was to investigate the association of immunosuppressive medication non-adherence and psychosocial factors.MethodsIn 330 adult renal transplant recipients (≥12 months posttransplantation), health-related quality of life, depression, anxiety, social support, and subjective medication experiences were assessed, and their associations with patient-reported non-adherence was evaluated.Results33.6% of the patients admitted to be partially non-adherent. Non-adherence was associated with younger age, poorer social support, lower mental, but higher physical health-related quality of life. There was no association with depression and anxiety. However, high proportions of clinically relevant depression and anxiety symptoms were apparent in both adherent and non-adherent patients.ConclusionIn the posttransplant follow-up, kidney recipients with lower perceived social support, lower mental and higher physical health-related quality of life, and younger age can be regarded as a risk group for immunosuppressive medication non-adherence. In follow-up contacts with kidney transplant patients, physicians may pay attention to these factors. Furthermore, psychosocial interventions to optimize immunosuppressive medication adherence can be designed on the basis of this information, especially including subjectively perceived physical health-related quality of life and fostering social support seems to be of importance.

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Section: Introductionmentioning

confidence: 99%

Psychosocial Variables Associated with Immunosuppressive Medication Non-Adherence after Renal Transplantation

et al. 2018

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“…Nach der Auswahl der geeigneten Immunsuppres sion ist die Adhärenz entscheidend für den Therapie erfolg [5,19]. Non-Adhärenz ist multifaktoriell und umfasst zum einen unabsichtlich non-adhärentes Verhalten z.…”

Section: Weitere Aspekte Zur Immunsuppression In Der Nachsorgeunclassified

“…Zum anderen ist auch eine bewusste Non-Adhärenz aufgrund von generellen Bedenken, aufgrund der Überzeugung, keine Medikation zu benötigen, oder aufgrund von Nebenwirkungen zu beobachten [19]. Die Aufklärung der Pa tienten über die Medikation, insbesondere über deren Nutzen und mögliche oder zu erwartende Nebenwirkungen, sowie entsprechendes Nebenwirkungsmanagement spielen daher eine große Rolle für die Therapieadhärenz [19]. Je besser die Information und der Wissensstand der Patienten, umso höher ist auch die Adhärenz [19].…”

Section: Weitere Aspekte Zur Immunsuppression In Der Nachsorgeunclassified

“…Die Aufklärung der Pa tienten über die Medikation, insbesondere über deren Nutzen und mögliche oder zu erwartende Nebenwirkungen, sowie entsprechendes Nebenwirkungsmanagement spielen daher eine große Rolle für die Therapieadhärenz [19]. Je besser die Information und der Wissensstand der Patienten, umso höher ist auch die Adhärenz [19].…”

Section: Weitere Aspekte Zur Immunsuppression In Der Nachsorgeunclassified

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Management der Immunsuppression nach Lebertransplantation (Sponsor: Novartis Pharma GmbH, Nürnberg)

2022

Therapieforum Transplant

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Eine langfristig erfolgreiche Immunsuppression nach Lebertransplantation umfasst neben der effizienten Abstoßungsprophylaxe auch weitere für den Langzeitverlauf bedeutende Therapieziele. Dazu gehören u. a. der Erhalt der Nierenfunktion, die Reduktion von Malignitäten, Infektionen und metabolischen sowie kardiovaskulären Komplikationen. Das unterschiedliche Wirkprofil der verschiedenen Substanzen erlaubt es, die geeignete Immunsuppression anhand der Therapieziele sowie des patientenindividuellen Risikos auszuwählen. Ebenso von großer Bedeutung ist eine kontinuierliche Optimierung der Immunsuppression. Neue Studiendaten zeigen den Stellenwert und Nutzen einer Immunsuppression mit Everolimus und reduziertem Tacrolimus nach Lebertransplantation.

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“…After KT or LT, immunosuppressive medication is required to prevent rejection. Lifelong adherence, the extent to which the patient’s behavior matches prescriber’s recommendations, to immunosuppressive medication is important to prevent graft failure ( Pabst et al, 2015 ; Nöhre et al, 2018 ). Nonetheless, many transplant recipients have difficulties when it comes to medication intake.…”

Section: Introductionmentioning

confidence: 99%

Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study

Wagner-Skacel

Fink²,

Kahn³

et al. 2023

Front. Psychol.

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IntroductionAlthough adherence to immunosuppressive medication is the key factor for long-term graft survival today, 20–70% of transplant recipients are non-adherent to their immunosuppressive medication.ObjectiveA prospective, randomized, controlled single-center feasibility study was designed to evaluate the impact of a step guided multicomponent interprofessional intervention program for patients after kidney or liver transplantation on adherence to their immunosuppressive medication in daily clinical practice.Materials and methodsThe intervention consisted of group therapy and daily training as well as individual sessions in a step guided approach. The primary endpoint of the study was adherence to immunosuppression as assessed with the “Basel Assessment of Adherence to Immunosuppressive Medications Scale” (BAASIS). The coefficient of variation (CV%) of Tacrolimus (TAC) through levels and the level of personality functioning was a secondary endpoint. We conducted six monthly follow-up visits.ResultsForty-one age- and sex-matched patients [19 females, 58.5 (SD = 10.56) years old, 22 kidney- and 19 liver transplantation] were randomized to the intervention- (N = 21) or control-group (N = 20). No differences between intervention- and control groups were found in the primary endpoint adherence and CV% of TAC. However, in further exploratory analyses, we observed that individuals with higher impairments in personality functioning showed higher CV% of TAC in the controls. The intervention might compensate personality-related susceptibility to poor adherence as evident in CV% of TAC.DiscussionThe results of the feasibility study showed that this intervention program was highly accepted in the clinical setting. The Intervention group could compensate higher CV% of TAC after liver or kidney transplantation in individuals with lower levels of personality functioning and non-adherence.Clinical trial registrationClinicalTrials.gov, identifier NCT04207125.

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Immunsuppressiva-Adhärenz nach Transplantation

Cited by 4 publications

References 63 publications

Psychosocial Variables Associated with Immunosuppressive Medication Non-Adherence after Renal Transplantation

Psychosocial Variables Associated with Immunosuppressive Medication Non-Adherence after Renal Transplantation

Management der Immunsuppression nach Lebertransplantation (Sponsor: Novartis Pharma GmbH, Nürnberg)

Improving adherence to immunosuppression after liver or kidney transplantation in individuals with impairments in personality functioning – A randomized controlled single center feasibility study

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