Medication beliefs and perceived barriers in adolescent renal transplant patients and their parents

Zelikovsky, Nataliya; Dobson, Tracey; Norman, Jessica

doi:10.1007/s00467-011-1805-1

Cited by 10 publications

(8 citation statements)

References 24 publications

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“…Findings related to adherence were similarly variable. In one US study, families with lower SES reported more barriers to their adolescent's medication taking 94 ; however, two US studies found no relation between SES and caregiver‐ or self‐reported adherence barriers 90,92 . Studies in Brazil 95 and the US 52 found higher income was associated with greater non‐adherence, while others in the US 88 and Guatemala 96 found no significant association between adherence and financial difficulties or income.…”

Section: Resultsmentioning

confidence: 95%

A systematic review of social determinants of health in pediatric organ transplant outcomes

Rea

West

Dorste

et al. 2022

Pediatric Transplantation

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Background: Equitable access to pediatric organ transplantation is critical, although risk factors negatively impacting pre-and post-transplant outcomes remain. No synthesis of the literature on SDoH within the pediatric organ transplant population has been conducted; thus, the current systematic review summarizes findings to date assessing SDoH in the evaluation, listing, and post-transplant periods. Methods: Literature searches were conducted in Web of Science, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature databases. Results: Ninety-three studies were included based on pre-established criteria and were reviewed for main findings and study quality. Findings consistently demonstrated disparities in key transplant outcomes based on racial or ethnic identity, including timing and likelihood of transplant, and rates of rejection, graft failure, and mortality. Although less frequently assessed, variations in outcomes based on geography were also noted, while findings related to insurance or SES were inconsistent. Conclusion: This review underscores the persistence of SDoH and disparity in equitable transplant outcomes and discusses the importance of individual and systems-level change to reduce such disparities. K E Y W O R D S social determinants of health, disparity, pediatric organ transplantation 2 of 33 | REA et al. 1 | INTRODUC TI ON Equitable access to organ transplantation and subsequent transplantrelated medical care is a critical goal across healthcare centers. Over the years, studies have identified risk factors impacting listing status and transplant-related outcomes, with greater scrutiny recently on clinical tools impacting organ allocation, selection, and donation processes. 1 These steps are critical in identifying areas of structural racism which continue to impact Black, Indigenous, and people of color as well as the intersectionality of socioeconomic factors within the patient population as a whole. To summarize findings to date, a systematic review of the available literature was conducted. Studies included assessments of SDoH in the evaluation, listing, and post-transplant periods. The US Department of Health and Human Services identifies five domains of SDoH that include economic stability, education access and quality, healthcare access and quality, neighborhood and built environment, and social and community context. 2 Special consideration was given to dynamic interplay between these factors to better understand social processes underlying health outcomes and identify potential intervention areas. | ME THODS | Search strategyThis systematic review is in accordance with PRISMA guidelines.Comprehensive search strategies were created for Web of Science, Embase, PubMed, and Cumulative Index to Nursing and Allied Health Literature, including controlled vocabulary terms from each database combined logically with keywords using Boolean Logic. Terms were extracted per the following concepts: pediatrics, organ transplantation, disparities, and identity (see example searc...

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Section: Resultsmentioning

confidence: 95%

A systematic review of social determinants of health in pediatric organ transplant outcomes

Rea

West

Dorste

et al. 2022

Pediatric Transplantation

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“…Weighing whether medications prescribed are necessary for one's physical well‐being while accepting the potential harmful side effects can be challenging for adolescents who want to feel and look normal in order to fit in with their peer group. In a prior study, younger adolescents expressed greater concerns about medications than older adolescents, with stronger beliefs about the harmfulness of their medications 25 . Among adults on dialysis and kidney transplant, 34.4% reported strong concerns about their medications (eg, long‐term effects, dependence) and 17.3% believed their medications to be harmful, while the majority (98.2%) strongly believed their medications to be necessary for their physical well‐being 26 .…”

Section: Beliefs About Medicinementioning

confidence: 94%

“…In a prior study, younger adolescents expressed greater concerns about medications than older adolescents, with stronger beliefs about the harmfulness of their medications. 25 Among adults on dialysis and kidney transplant, 34.4% reported strong concerns about their medications (eg, long-term effects, dependence) and 17.3% believed their medications to be harmful, while the majority (98.2%) strongly believed their medications to be necessary for their physical wellbeing. 26 Patient beliefs that medication is necessary was related to better adherence in dialysis patients 27 while lower perceived benefits, perceived harmfulness, and greater concerns about medication were associated with lower adherence in transplant samples.…”

Section: B Eliefs About Med I Cinementioning

confidence: 99%

Illness perceptions and beliefs about medication: impact on health‐related quality of life in adolescent kidney transplant recipients

Zelikovsky

Nelson

2021

Pediatric Transplantation

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There are approximately 10,000 children and adolescents living with CKD in the United States, with a prevalence of 124.2 males and 90.6 females per million. 1 Symptoms of CKD include fatigue, swelling, increased urination, decreased concentration, yellowing/ dryness of the skin, and a shorter stature. Effects of CKD include waste buildup, anemia, high blood pressure, and nerve damage. 1 Kidney transplantation is the optimal intervention and a preferable alternative to dialysis treatment; however, organ transplantation is

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“…They begin to assume responsibility for their healthcare and become less dependent on their families. It has been reported adolescent recipients after transplantation might have increased susceptibility to psychological illnesses and are prone to develop non-adherence to immunosuppressive medications, which might lead to rejection (35)(36)(37)(38). In the adolescent group, 40% (4/10) of patients with rejection eventually progressed to graft loss, whereas this number was 28.57% (4/14) in the child group and 6.25% (1/16) in the adult group.…”

Section: Discussionmentioning

confidence: 99%

Single kidney transplantation from pediatric deceased donors in China: the outcomes and risk factors of graft survival

Huang¹,

Wu²,

Zhang³

et al. 2022

Transl Pediatr

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Background: Pediatric deceased donors offer great potential for expanding the organ donor pool. The utilization of pediatric donor kidneys has been explored by numerous transplant centers; however, the transplant outcome and risk factors have not been well elucidated. The aim of this study was to demonstrate the safety and risk factors of transplant outcome from pediatric deceased donors.Methods: We retrospectively analyzed 484 cases of single kidney transplantation (SKT) with pediatric donor kidneys performed at our center from January 2012 to March 2021. The recipients were grouped by age: child (≤12 years; n=143), adolescents (12-18 years; n=86), and adults (≥18 years; n=255). The overall prognosis of the recipients was analyzed, and the post-transplant outcomes were compared among the three groups and assessed by univariate and multivariate analyses using the Cox proportional risk model. Results:The median follow-up time was 26.7 months. The 1-and 3-year patient survival rates were 98.7% and 96.8%, respectively. The 1-and 3-year death-censored graft survival (DCGS) was 96.1% and 92.7%, respectively. The overall estimated glomerular filtration rates (eGFRs) at 1 and 3 years were 80.0±24.5 and 84.2±25.2 mL/min/1.73 m 2 ; the 3-year eGFR of the three groups were comparable and all were over 80 mL/min/1.73 m 2 . Rejection was an independent risk factor for death-censored graft failure within 3 years after transplantation [hazard ratio (HR) =3.85; P=0.001], and was the primary cause of graft losses in the adolescent group. Thrombosis was more common within 1-month post-transplant in the child recipients (P<0.05), and its incidence was higher in recipients with donor body weight (DBW) ≤11 kg.Conclusions: SKT from pediatric donors could achieve decent outcomes. Rejection was an independent risk factor of graft survival, especially for adolescent recipients. Child recipients may compromise early transplant outcomes due to vascular thrombosis, which might be related to small (DBW ≤11 kg) pediatric donors.

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Medication beliefs and perceived barriers in adolescent renal transplant patients and their parents

Cited by 10 publications

References 24 publications

A systematic review of social determinants of health in pediatric organ transplant outcomes

A systematic review of social determinants of health in pediatric organ transplant outcomes

Illness perceptions and beliefs about medication: impact on health‐related quality of life in adolescent kidney transplant recipients

Single kidney transplantation from pediatric deceased donors in China: the outcomes and risk factors of graft survival

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