Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study

Senft, Yuliya; Kirsch, Monika; Denhaerynck, Kris; Dobbels, Fabienne; Helmy, Remon; Russell, Cynthia L.; Berben, Lut; Geest, Sabina De

doi:10.1177/1474515117747577

Cited by 21 publications

(11 citation statements)

References 44 publications

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“… 15 16 The most frequently employed NA measure for HTRs is self-report. 16 Despite their susceptibility to errors, such as memory bias and social desirability, self-reports are considered practical and inexpensive tools for NA assessment. 15 17–20 Although electronic monitoring allows insights into patterns of adherence behaviour, its use can be quite expensive and labour intensive.…”

Section: Introductionmentioning

confidence: 99%

“… 15 17 Except for few studies, 2 5 14 electronic monitoring is only very sparsely used in HTRs. 16 Blood assays such as the trough-level variability are also frequently applied as an adherence measure, since they have increasingly been associated with rejection and mortality in HTRs. 13 21 22 Collateral reports, however, are mostly considered unreliable measurement methods for NA.…”

Section: Introductionmentioning

confidence: 99%

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Prospective single-centre clinical observational study on electronically monitored medication non-adherence, its psychosocial risk factors and lifestyle behaviours after heart transplantation: a study protocol

et al. 2020

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IntroductionIn heart transplant recipients (HTRs), non-adherence (NA) to immunosuppressive (IS) medication and to recommended lifestyle behaviours are a common phenomenon and associated with higher risk of allograft rejection, organ loss and mortality. Risk factors for NA are highly diverse and still insufficiently researched. Precise measures of NA and an accurate understanding of its aetiology are of undisputable importance to detect patients at risk and intervene accordingly. The aim of this study is to assess the accuracy and concordance of different measures for NA as well as to determine potential risk factors.Methods and analysisThis is a single-centre prospective observational trial. HTRs who are at least aged 18 are no less than 6 months post-transplant and receive tacrolimus (Prograf or Advagraf), cyclosporine (Sandimmun) or everolimus (Certican) as their prescribed IS medication are eligible for participation. We only include patients during the phase of medication implementation. At study enrolment, we assess depression, health-related quality of life, self-efficacy, social support, attachment, experiences and attitudes towards IS medication, emotional responses after transplantation, satisfaction with information about IS medication and perceptions and beliefs about medications. We further ask patients to rate their lifestyle behaviours concerning alcohol, smoking, diet, physical activity, sun protection and appointment keeping via questionnaires. Three different measurement methods for NA are applied at T0: self-reports, physician’s estimates and IS trough levels. NA is monitored prospectively using an electronic multicompartment pillbox (MEMS, VAICA) over a 3-month period. Meanwhile, participants receive phone calls every second week to obtain additional self-reports, resulting in a total of seven measurement points.Ethics and disseminationThe study was approved by the Clinical Ethics Committee of the University Hospital Erlangen (Friedrich-Alexander-University, Erlangen-Nürnberg). Written informed consent is attained from all participants. The results of this study will be published in peer-reviewed journals and presented at conferences.Trial registration numberDRKS00020496.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prospective single-centre clinical observational study on electronically monitored medication non-adherence, its psychosocial risk factors and lifestyle behaviours after heart transplantation: a study protocol

et al. 2020

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“…Heart transplant recipients require numerous medications with complex treatment regimens, including immunosuppressants 2,3. Life-long immunosuppression is often critical for solid organ recipients to prevent graft rejection from an immune response 4,5. Near-perfect adherence to immunosuppressants is crucial to achieving optimal long-term graft survival 2,6.…”

Section: Introductionmentioning

confidence: 99%

<p>Prevalence and Risk Factors of Immunosuppressant Nonadherence in Heart Transplant Recipients: A Single-Center Cross-Sectional Study</p>

Zhang¹,

Zhou²,

Nelson³

et al. 2019

PPA

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BackgroundImmunosuppressant nonadherence (INA) has been shown to affect outcomes after solid organ transplantation. The aim of the present study was to determine the prevalence of INA in heart transplant recipients and the associated risk factors of INA.MethodsAdult heart transplant recipients who firstly received heart transplantation (discharged for at least 3 months) were consecutively enrolled. Immunosuppressant adherence was assessed using the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS). INA was categorized into five domains of contributing factors (socio-demographic factors, transplant-related factors, healthcare system access factors, post-transplant treatment-related factors, and patient-related psychosocial factors). These factors were compared between adherent and nonadherent patients. The risk factors of INA were investigated by logistic regression analysis.ResultsA total of 168 heart recipients were ultimately included. Among them, 69 (41.1%) recipients were revealed to be nonadherent. Logistic regression analysis indicated that INA was associated with monthly income<3000 Chinese Yuan (CNY) (OR, 3.11; 95% CI, 1.58–6.12; p=0.001), number of prescribed concomitant drugs (OR, 1.23; 95% CI, 1.12–1.50; p=0.003) and concerns about immunosuppressants (OR, 1.09; 95% CI, 1.01–1.18; p=0.031).ConclusionsHeart recipients had a high prevalence of INA. Lower income, greater number of prescribed concomitant drugs, and more concerns about immunosuppressants correlated most with timing nonadherence and taking nonadherence among heart recipients. These findings will be helpful to intervene on and prevent future INA of heart recipients.

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“…Because of its striking amplitude, medication adherence is a topic regularly addressed in the European Journal of Cardiovascular Nursing and the Journal of Cardiovascular Nursing. [1][2][3][4] Indeed, nurses as part of multidisciplinary healthcare teams play a crucial role in medication adherence management in different healthcare settings. Nurses drive innovation in medication adherence management.…”

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confidence: 99%

Improving medication adherence research reporting: ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

Geest

Zullig

Dunbar‐Jacob

et al. 2019

European Journal of Cardiovascular Nursing

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Practice patterns to improve pre and post-transplant medication adherence in heart transplant centres: a secondary data analysis of the international BRIGHT study

Abstract: Across the transplant continuum, diverse adherence interventions are implemented; however, post-transplant, the frequency of adherence interventions decreases. Therefore, increased investment is necessary in long-term adherence interventions.

Cited by 21 publications

References 44 publications

Prospective single-centre clinical observational study on electronically monitored medication non-adherence, its psychosocial risk factors and lifestyle behaviours after heart transplantation: a study protocol

Prospective single-centre clinical observational study on electronically monitored medication non-adherence, its psychosocial risk factors and lifestyle behaviours after heart transplantation: a study protocol

<p>Prevalence and Risk Factors of Immunosuppressant Nonadherence in Heart Transplant Recipients: A Single-Center Cross-Sectional Study</p>

Improving medication adherence research reporting: ESPACOMP Medication Adherence Reporting Guideline (EMERGE)

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