Pragmatic solutions to enhance self-management skills in solid organ transplant patients: systematic review and thematic analysis

Abstract

Background In organ transplantation, all patients must follow a complex treatment regimen for the rest of their lives. Hence, patients play an active role in the continuity of the care process in the form of self-management tasks. Thus, the main objective of our study was to investigate the pragmatic solutions applied by different studies to enhance adherence to self-management behaviors. Method A systematic review was conducted in five databases from 2010 to August 2021 using keywords. Eligible studies were all English papers that developed self-management programs to enhance patient care in solid organ transplantation. The interventions were analyzed using thematic analysis to determine the main descriptive areas. The quality of the included articles was evaluated using the research critical appraisal program (CASP) tool. Results Of the 691 retrieved articles, 40 met our inclusion criteria. Of these, 32 studies were devoted to the post-transplantation phase. Five main areas were determined (e-health programs for telemonitoring, non-electronic educational programs, non-electronic home-based symptom-monitoring programs, electronic educational plans for self-monitoring, and Telerehabilitation) according to thematic analysis. Most studies (72.5%) declared that developed programs and applied solutions had a statistically significant positive impact on self-management behavior enhancement in transplant patients. Conclusion The results showed that an effective solution for improving organ transplantation needs patient collaboration to address psychological, social, and clinical aspects of patient care. Such programs can be applied during candidate selection, waiting list, and after transplantation by putting the patient at the center of care.

Feasibility study and determination of prerequisites of telecare programme to enhance patient management in lung transplantation: a qualitative study from the perspective of Iranian healthcare providers

“…8 9 The adoption of telemedicine services in other solid organ transplant care has shown the great potential of telehealth technology to improve the healthcare delivery model by providing increased patient-to-healthcare team interactions and accessibility. [8][9][10][11][12][13] Such programmes engage transplant patients in their self-management activities and enhance the doctorpatient relationship.…”

“…Evidence showed that supporting transplant patients with additional technology-based support care programmes alongside traditional care could provide real-time patient access to the transplant team and emergency medical services 8 9. The adoption of telemedicine services in other solid organ transplant care has shown the great potential of telehealth technology to improve the healthcare delivery model by providing increased patient-to-healthcare team interactions and accessibility 8–13. Such programmes engage transplant patients in their self-management activities and enhance the doctor–patient relationship.…”

Defining Self-Management for Solid Organ Transplantation Recipients: A Mixed Method Study

“…For SOTx patients, absence or insufficient attention to self-management can result in such complications [ 4 ]. Typically, patients need to monitor signs of infection, medication side-effects, and physical and psychological status and implement healthy lifestyle changes (such as a special diet, psychosocial problems, mental health problems, and substance use) [ 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. In terms of a medication regimen, patients must learn how to calculate dosages of interacting medications.…”

Self‐management skills in a UK sample of young people with chronic liver disease

“…There is evidence of an association between self‐management behaviors and improved health outcomes in adults, such as physical activity post‐transplant, 10 and interventions aimed at improving self‐management behaviors are considered ‘crucial for better outcomes’ 11 . However, an increasing body of research into adolescent patients, including those of other chronic illness populations in which a high level of self‐management is required, for example HIV and diabetes, 12,13 indicates that taking on more responsibility for such tasks is associated with poorer outcomes.…”

“…9 There is evidence of an association between self-management behaviors and improved health outcomes in adults, such as physical activity post-transplant, 10 and interventions aimed at improving self-management behaviors are considered 'crucial for better outcomes'. 11 However, an increasing body of research into adolescent patients, including those of other chronic illness populations in which a high level of self-management is required, for example HIV and diabetes, 12,13 indicates that taking on more responsibility for such tasks is associated with poorer outcomes. In organ transplant recipients, Fredericks et al 14 found an increase in perceived selfmanagement skills and regimen knowledge with chronological age, but the association between age and performance on the domain assessing these skills did not reach statistical significance.…”