Medication Non-adherence Prevalence and Determinants in Children and Adolescents with Chronic Liver Diseases

Dehghani, Seyed Mohsen; Shamsaeefar, Alireza; Kazemi, Azar; Kazemi, Kourosh; Mashhadiagha, Amirali; Moosavi, Seyed Amir; Motazedian, Nasrin; Nikeghbalian, Saman; Malekhosseini, Seyed Ali

doi:10.5812/ijp.112323

Cited by 4 publications

(2 citation statements)

References 27 publications

(35 reference statements)

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“…Chronic liver diseases (CLD), including cirrhosis, have been augmenting dramatically worldwide, and by now, liver transplantation (LT) is considered as a mere ultimate treatment of people who suffer from CLD. 1,2 Besides all the surviving advantages of LT, it may result in several lifethreatening consequences via different paths. To avoid organ rejection, recipients should take immunosuppressant agents, which suppress the immune systems, and several opportunistic microorganisms would find a chance to present.…”

Section: Introductionmentioning

confidence: 99%

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Isoniazid prophylaxis in liver transplant recipient with latent tuberculosis: Is it harmful for transplanted liver?

Ghayumi

Shamsaeefar

Motazedian

et al. 2022

Transplant Infectious Dis

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Background: Liver transplantation (LT) is considered the only treatment for patients with end-stage liver disease and, despite its incredible impacts on the patients' health status, places them in an immunocompromised state in which opportunistic infection would find a way to present. Latent tuberculosis infection (LTBI) is the most common form of TB and can be diagnosed through tuberculin skin test (TST) or Interferon-Gamma Release Assays (IGRA). LT recipients are at significant risk of TB activation.There is no strict guideline to approaching these cases though, in most centers, Isoniazid (INH) would be prescribed prophylactically. INH is a hepatotoxic medication and can have adverse effects on the transplanted liver. There is no consensus on this issue; therefore, we aimed to survey the potential hepatotoxic effects of INH among LT recipients in Shiraz, Iran.Methods: A retrospective cohort study was conducted among LT candidates and recipients at Abu Ali Sina Organ Transplantation Center between 1993 and 2019. All the cases underwent TST and chest X-ray to detect LTBI. All the LTBI were treated with INH from 6-9 months and followed by the level of liver enzymes for quick detection of hepatotoxicity. A control group was selected among LT recipients and matched for age, gender, MELD score, and donor age.Results: Among 4895 medical records reviewed, 55 (1.12%) cases had LTBI. Neither INH-related hepatotoxicity, nor signs and symptoms that were suspicious to TB reactivation were reported. Overall, three deaths were reported, two because of myocardial infarction and one due to pneumonia. Ten patients (18.2%) experienced acute rejection as confirmed with pathology and responded to methylprednisolone.Aspartate aminotransferase (AST) was diminished from pre-LT time to the first time after transplantation; after that, it showed a steady pattern. Meanwhile, Alanine transaminase (ALT) was constant before and one stage later and decreased after that.Statistical analyses only showed significant changes in the total bilirubin titer between the case and control groups. Conclusion:This survey showed prophylactic management of LTBI with INH in LT candidates and recipients was associated with no hepatotoxicity or related death. It seems

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Isoniazid prophylaxis in liver transplant recipient with latent tuberculosis: Is it harmful for transplanted liver?

Ghayumi

Shamsaeefar

Motazedian

et al. 2022

Transplant Infectious Dis

Self Cite

View full text Add to dashboard Cite

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Study of Adherence to Medication in Pediatric Liver Diseases (“SAMPLD” Study) in Indian Children

Suchismita¹,

Ashritha²,

Vikrant³

et al. 2023

Journal of Clinical and Experimental Hepatology

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Predictors of Compliance to Gluten-Free Diet in Children with Celiac Disease

et al. 2022

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Background: Celiac disease (CD) is a common autoimmune disorder that presents intestinal and extra-intestinal symptoms. It is also associated with cardiovascular diseases and malignancies, and mortality risk. The only way to control the disease is to follow a strict gluten-free diet (GFD) for the rest of life. Objectives: This survey aimed to investigate GFD non-adherence and causes in the pediatric setting. Methods: In this study, 187 children aged between 2.5 to 14 years old with a confirmed diagnosis of CD at least for a year were studied using a questionnaire-based interview in a census study between 2018 to 2019 in a referral center in southern Iran. Results: About 40% of children adhered to a GFD poorly. This group significantly complained of more symptoms than the group with high adherence. Improper access was the most important cause of non-adherence to a GFD. Among the analyzed variables, the mean current weight and at the time of diagnosis, along with the mean current body mass index (BMI) and at the time of diagnosis, were statistically significant, which were respectively lower and higher in the non-adherent group. However, IgA anti-tTG and histopathologic examination did not change remarkably. Furthermore, no significant relationship was found between following a GFD and age, age at the time of diagnosis, gender, and parental educational status. Conclusions: According to our results, inaccessibility, high costs, and lack of food labeling were the primary reasons for non-adherence to GDF. Therefore, to increase compliance, easy access to GFD with proper food labeling and suitable price should be implemented.

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Medication Non-adherence Prevalence and Determinants in Children and Adolescents with Chronic Liver Diseases

Cited by 4 publications

References 27 publications

Isoniazid prophylaxis in liver transplant recipient with latent tuberculosis: Is it harmful for transplanted liver?

Isoniazid prophylaxis in liver transplant recipient with latent tuberculosis: Is it harmful for transplanted liver?

Study of Adherence to Medication in Pediatric Liver Diseases (“SAMPLD” Study) in Indian Children

Predictors of Compliance to Gluten-Free Diet in Children with Celiac Disease

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