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Böbrek Nakli Yapılan Hastalarda Sosyo-Demografik ve Klinik Özelliklerin İmmünosupresif Uyumuna Etkisinin Değerlendirilmesi: Tek Merkezli Çalışma

Year 2022, Volume: 7 Issue: 2, 188 - 195, 01.06.2022
https://doi.org/10.26453/otjhs.999666

Abstract

Amaç: Bu araştırmada böbrek nakli yapılan hastaların ilaç uyum oranlarını, sosyo-demografik ve klinik özelliklerin immünosupresif uyumuna etkisini değerlendirmek amaçlanmaktadır.



Materyal ve Metot: Araştırma tek merkezli olarak kesitsel tanımlayıcı planlandı ve gerçekleştirildi. Araştırmaya organ nakli merkezinde son 6 yılda (2015-2021) böbrek nakli yapılan 210 hasta dahil edildi. Araştırmada veri toplama araçları olarak; “Hasta Bilgi Formu”, Böbrek Nakli Hastaları İçin İlaç İzlem Formu”, “İmmünosüpresif Tedaviye Uyum Ölçeği” kullanıldı.



Bulgular: Çalışmaya alınan hastaların İmmünosüpresif Tedaviye Uyum Ölçeği toplam puanları ortalama 11,16±0,82 olarak bulundu ve %57,9’unun immünosupresif ilaç kullanımına çok iyi uyum gösterdiği belirlendi. Sosyodemografik özelliklerden evli, üniversite mezunu, yüksek gelire sahip olanlarda İmmünosüpresif Tedaviye Uyum Ölçeği toplam puanları yüksek bulundu. Klinik özelliklerden ise bir günde kullanılan ilaç adedi arttıkça katılımcıların İmmünosüpresif Tedaviye Uyum Ölçeği puanlarının azaldığı saptandı. İlaç kullanımına yönelik eğitim alanlarda, immünosupresif ilaçların yan etkileri olmayan katılımcılarda İmmünosüpresif Tedaviye Uyum Ölçeği toplam puanları daha yüksek bulundu.



Sonuç: Böbrek nakli yapılan merkezlerde hastaların immünosupresif ilaç uyumlarının düzenli olarak kontrol edilmesi, uyumsuzluğa etki eden faktörlerin belirlenerek uyumu arttırıcı doğru yaklaşım yöntemlerinin geliştirilmesi, yaygınlaşması, süreklilik kazanması ve bunun hastane protokollerine eklenmesi gerektiğini düşünmekteyiz.

References

  • Russell C, Conn V, Ashbaugh C, ve ark. Taking immunosuppressive medications effectively (TIMELink): a pilot randomized controlled trial in adult kidney transplant recipients. Clinical Transplant. 2011;25(6):864‐870.
  • Taber JD, Fleming NJ, Fominaya EC, ve ark. The impact of health care appointment nonadherence on graft outcomes in kidney transplantation. Am J Nephrol. 2017;45:91-98. doi:10.1159/000453554
  • Williams FA, Manias E, Gaskin CJ, Crawford K. Medicine non-adherence in kidney transplantation. Journal of Renal Care. 2014;40(2):107-116. doi:10.1111/jorc.12063
  • Checchi KD, Huybrechts KF, Avorn J, Kesselheim AS. Electronic medication packaging devices and medication adherence: a systematic review. JAMA. 2014;312(12):1237-1247. doi:10.1001/jama.2014.10059
  • Blaseer DL, Matteson M, Dobbels F, Russel C, Geest DS. Interventions to improve medication-adherence after transplantation: A systematic review. Transplant Inernational. 2009;22(8):780-797. doi:10.1111/j.1432-2277.2009.00881.x
  • Gorevski E, Succop P, Sachdeva J, ve ark. There an association between ımmunosuppressant therapy medication adherence and depression, quality of life and personality traits in the kidney and liver transplant population. Patient Preferance and Adherence. 2013;7:301-307. doi:10.2147/PPA.S34945
  • Chisholm-Burns MA, Spivey CA, Rehfeld R, ve ark. Immunosuppressant therapy adherence and graft failure among pediatric renal transplant cecipients. American Journal of Transplantation. 2009;9:497–2504. doi: 10.1111/j.1600-6143.2009.02793.x
  • Gonçalves PRC, Reveles AF, Martins HIF, Rodrigues IL, Rodrigues SMM. Adherence to ımmunosuppressive therapy in kidney transplant recipients: ıntegrative literature review. Revista de Enfermagem Referencia. Journal of Nursing Referencia. 2016;4(8):121-130. doi:10.1111/jorc.12181
  • Dew MA, DiMartini AF, De Vito Dabbs. A rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation.2007;83(7):858-873. doi:10.1097/01. tp.0000258599.65257.a6
  • 10.De Geest S, Schafer KP, Denhaerynck K, Thannberger N, Köfer S, Bock A. Supporting medication adherence in renal transplantation (SMART): A pilot RCT to improve adherence to immunosuppressive regimens. Clintransplant. 2006;20:359–368.
  • Garcia MF, Bravin AM, Garcia PD, Contti MM, Nga HS, Takase HM. Behavioral measures to reduce non-adherence in renal transplant recipients: aprospective randomized controlled trial. Int Urol Nephrol. 2015; 47(11):1899-1905. doi:10.1007/s11255-015-1104-z
  • Chisholm-Burns MA, Pinsky B, Parker G, Johnson P, Arcona S, Buzinec P. Factor related to immunosupressant medication adherence in renal transplant recipients. Clin Transplant. 2012;26:706-713. doi:10.1111/j.1399-0012.2011.01589.x
  • Bayhan B. Organ nakli hastalarında immunsupresif tedaviye uyum ölçeği'nin Türkiye'de geçerlik güvenirliği. Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi. İzmir, Türkiye. 2014.
  • Zhu Y, Zhou Y, Zhang L, Zhang J, Lin J. Efficacy of interventions for adherence to the immunosuppressive therapy in kidney transplant recipients: A meta-analysis and systematic review. J Investig Med. 2017; 65(7):1049–1056. doi:10.1136/jim-2016-000265
  • Ganjali R, Sabbagh MG, Nazemiyan F, Mamdouhi F, Aval BS, Taherzadeh Z. Factors associated with adherence to ımmunosuppressive therapy and barriers ın asian kidney transplant recipients. Immunotargets Ther. 2019;8:53. doi:10.2147%2FITT.S212760
  • Gokoel SRM, Handoko KBG, Zwart TC, Paul JM, Moes DJAR, Fijter JW. Medication non-adherence after kidney transplantation: A critical appraisal and systematic review. Transplant Review. 2020;34(1):100511. doi:10.1016/j.trre.2019.100511
  • Özdemir Z, Talas MS. Solid organ transplantasyonu sonrası immünsupresif ilaç kullanımına uyum. Anadolu Hem Sağ Bil Derg, 2017;20(4):304-310.
  • MacLaughlin EJ, Raehl CL, Treadway AK, Sterling TL, Zoller DP, Bond C. Assessing medication adherence in the elderly. which tools to use in clinical practice? Drug Aging. 2005;22(3):231-55. doi:10.2165/00002512-200522030-00005
  • Weng F, Sheenu C, Kurtyka KM, Zacker C, Chisholm-Burns M, Demissie K. Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study. BMC Nephrology. 2013;14:261. doi:10.1186/1471-2369-14-261
  • Belaiche S, Décaudin B, Dharancy S, Noel C, Odou P, Hazzan M. Factors relevant to medication non-adherence in kidney transplant: a systematic review. Int. J. Clin. Pharm. 2017;39(3):582–593. doi:10.1007/s11096-017-0436-4
  • Julia B, Pai ALH, Dharnidharka VR, ve ark. Gender differences in medication adherence among adolescent and young adult kidney transplant recipients. Transplantation. 2019;103(4):798–806. doi:10.1097/TP.0000000000002359
  • Liu J, Zhu X, Yan J, ve ark. Association between regulatory emotional self-efficacy and ımmunosuppressive medication adherence in renal transplant recipients:does medication belief act as a mediator? Front. Pharmacol. 2021;12:559368. doi:10.3389/fphar.2021.559368
  • Low KL, Williams A, Manias E, Crawford K. Interventions to improve medication adherence in adult kidney transplant recipients: a systematic review. Nephrology Dialysis. 2015;30(5):752-61. doi:10.1093/ndt/gfu204
  • Caroline S, Campos RN, Gustavo F, ve ark. Immunosuppressive adherence after kidney transplantation in adult patients treated at an outpatient clinic: a better practice implementation project. JBI Evid Implement. 2021;19:306-314. doi:10.1097/XEB.0000000000000262
  • Chisholm MA, Lance C, Williamson GM, Mulloy LL. Development and validation of the immunosuppressant therapy adherence instrument (ITAS). Patient Education and Counseling. 2004;59(2005):13-20.
  • Oh CK, BaeBang J, Kim SJ, HaHuh K. Improvement of medication adherence with simplified once-daily immunosuppressive regimen in stable kidney transplant recipients: A prospective cohort study. Asian Journal of Surgery. 2020;43(6):660-667. doi:10.1016/j.asjsur.2019.07.011
  • Vankova B, Ladova KM, Kubena AA, Maly J,  Sulkova SD. Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients. Patient Prefer Adherence. 2018;12:2605-2613. doi:10.2147/PPA.S184166
  • Daniela MS, Laura LR, Curtis M, ve ark. Transplant regimen adherence for kidney recipients by engaging information technologies (TAKE IT): Rationale and methods for a randomized controlled trial of a strategy to promote medication adherence among transplant recipients. Contemporary Clinical Trials. 2021;103:1551-7144. doi:10.1016/j.cct.2021.106294
  • Gustavsen MT, Midtvedt K, Lonning K, ve ark. Evaluation of tools for annual capture of adherence to immunosuppressive medications after renal transplantation – a single‐centre open prospective trial. Transplant International. 2019;32:614-625. doi:10.1111/tri.13412
  • Ahram Han A, Min Sİ, Ahn, S, ve ark. Mobile medication manager application to improve adherence with immunosuppressive therapy in renal transplant recipients: A randomized controlled trial. PLoS ONE. 2019;14(11):e0224595. doi:10.1371/journal.pone.0224595

Assessment of the Effect of Socio-Demographic and Clinical Characteristics on Immunosuppressive Adherence in Kidney Transplant Patients: A Single Center Study

Year 2022, Volume: 7 Issue: 2, 188 - 195, 01.06.2022
https://doi.org/10.26453/otjhs.999666

Abstract

Objective: The aim of this study to assess the medication adherence rates of renal-transplant recipients and the effect of socio-demographic and clinical characteristics on immunosuppressive adherence.



Materials and Methods: This study was designed as a single center, cross-sectional descriptive study. 210 patients who underwent kidney transplant in the last 6 years (2015-2021) at the organ transplant center were included in the study. Data collection tools included a “Patient Information Form,” “Drug Monitoring Form for Kidney Transplant Patients,” the “Immunosuppressive Therapy Adherence Scale”.



Results: Immunosuppressive Therapy Adherence Scale mean scores of the patients was 11.6±0.82 and 57.9% of them were very good at adherence. Among the sociodemographic characteristics, those who were married, university graduates, and had high income had higher total Immunosuppressive Therapy Adherence Scale scores. As for the clinical features, it was determined that as the number of drugs used in a day increased, the participants' Immunosuppressive Therapy Adherence Scale scores decreased. The participants who received training on drug use and who did not have the side effects of immunosuppressive drugs had higher Immunosuppressive Therapy Adherence Scale total scores.



Conclusion: We are of opinion kidney transplantation centers is performed, the adherence of patients with immunosuppressive agents should be regularly checked, the factors affecting non-adherence should be determined, and the correct approach methods should be developed, widespread, sustained, and added to hospital protocols.

References

  • Russell C, Conn V, Ashbaugh C, ve ark. Taking immunosuppressive medications effectively (TIMELink): a pilot randomized controlled trial in adult kidney transplant recipients. Clinical Transplant. 2011;25(6):864‐870.
  • Taber JD, Fleming NJ, Fominaya EC, ve ark. The impact of health care appointment nonadherence on graft outcomes in kidney transplantation. Am J Nephrol. 2017;45:91-98. doi:10.1159/000453554
  • Williams FA, Manias E, Gaskin CJ, Crawford K. Medicine non-adherence in kidney transplantation. Journal of Renal Care. 2014;40(2):107-116. doi:10.1111/jorc.12063
  • Checchi KD, Huybrechts KF, Avorn J, Kesselheim AS. Electronic medication packaging devices and medication adherence: a systematic review. JAMA. 2014;312(12):1237-1247. doi:10.1001/jama.2014.10059
  • Blaseer DL, Matteson M, Dobbels F, Russel C, Geest DS. Interventions to improve medication-adherence after transplantation: A systematic review. Transplant Inernational. 2009;22(8):780-797. doi:10.1111/j.1432-2277.2009.00881.x
  • Gorevski E, Succop P, Sachdeva J, ve ark. There an association between ımmunosuppressant therapy medication adherence and depression, quality of life and personality traits in the kidney and liver transplant population. Patient Preferance and Adherence. 2013;7:301-307. doi:10.2147/PPA.S34945
  • Chisholm-Burns MA, Spivey CA, Rehfeld R, ve ark. Immunosuppressant therapy adherence and graft failure among pediatric renal transplant cecipients. American Journal of Transplantation. 2009;9:497–2504. doi: 10.1111/j.1600-6143.2009.02793.x
  • Gonçalves PRC, Reveles AF, Martins HIF, Rodrigues IL, Rodrigues SMM. Adherence to ımmunosuppressive therapy in kidney transplant recipients: ıntegrative literature review. Revista de Enfermagem Referencia. Journal of Nursing Referencia. 2016;4(8):121-130. doi:10.1111/jorc.12181
  • Dew MA, DiMartini AF, De Vito Dabbs. A rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation.2007;83(7):858-873. doi:10.1097/01. tp.0000258599.65257.a6
  • 10.De Geest S, Schafer KP, Denhaerynck K, Thannberger N, Köfer S, Bock A. Supporting medication adherence in renal transplantation (SMART): A pilot RCT to improve adherence to immunosuppressive regimens. Clintransplant. 2006;20:359–368.
  • Garcia MF, Bravin AM, Garcia PD, Contti MM, Nga HS, Takase HM. Behavioral measures to reduce non-adherence in renal transplant recipients: aprospective randomized controlled trial. Int Urol Nephrol. 2015; 47(11):1899-1905. doi:10.1007/s11255-015-1104-z
  • Chisholm-Burns MA, Pinsky B, Parker G, Johnson P, Arcona S, Buzinec P. Factor related to immunosupressant medication adherence in renal transplant recipients. Clin Transplant. 2012;26:706-713. doi:10.1111/j.1399-0012.2011.01589.x
  • Bayhan B. Organ nakli hastalarında immunsupresif tedaviye uyum ölçeği'nin Türkiye'de geçerlik güvenirliği. Dokuz Eylül Üniversitesi Sağlık Bilimleri Enstitüsü, Yüksek Lisans Tezi. İzmir, Türkiye. 2014.
  • Zhu Y, Zhou Y, Zhang L, Zhang J, Lin J. Efficacy of interventions for adherence to the immunosuppressive therapy in kidney transplant recipients: A meta-analysis and systematic review. J Investig Med. 2017; 65(7):1049–1056. doi:10.1136/jim-2016-000265
  • Ganjali R, Sabbagh MG, Nazemiyan F, Mamdouhi F, Aval BS, Taherzadeh Z. Factors associated with adherence to ımmunosuppressive therapy and barriers ın asian kidney transplant recipients. Immunotargets Ther. 2019;8:53. doi:10.2147%2FITT.S212760
  • Gokoel SRM, Handoko KBG, Zwart TC, Paul JM, Moes DJAR, Fijter JW. Medication non-adherence after kidney transplantation: A critical appraisal and systematic review. Transplant Review. 2020;34(1):100511. doi:10.1016/j.trre.2019.100511
  • Özdemir Z, Talas MS. Solid organ transplantasyonu sonrası immünsupresif ilaç kullanımına uyum. Anadolu Hem Sağ Bil Derg, 2017;20(4):304-310.
  • MacLaughlin EJ, Raehl CL, Treadway AK, Sterling TL, Zoller DP, Bond C. Assessing medication adherence in the elderly. which tools to use in clinical practice? Drug Aging. 2005;22(3):231-55. doi:10.2165/00002512-200522030-00005
  • Weng F, Sheenu C, Kurtyka KM, Zacker C, Chisholm-Burns M, Demissie K. Prevalence and correlates of medication non-adherence among kidney transplant recipients more than 6 months post-transplant: a cross-sectional study. BMC Nephrology. 2013;14:261. doi:10.1186/1471-2369-14-261
  • Belaiche S, Décaudin B, Dharancy S, Noel C, Odou P, Hazzan M. Factors relevant to medication non-adherence in kidney transplant: a systematic review. Int. J. Clin. Pharm. 2017;39(3):582–593. doi:10.1007/s11096-017-0436-4
  • Julia B, Pai ALH, Dharnidharka VR, ve ark. Gender differences in medication adherence among adolescent and young adult kidney transplant recipients. Transplantation. 2019;103(4):798–806. doi:10.1097/TP.0000000000002359
  • Liu J, Zhu X, Yan J, ve ark. Association between regulatory emotional self-efficacy and ımmunosuppressive medication adherence in renal transplant recipients:does medication belief act as a mediator? Front. Pharmacol. 2021;12:559368. doi:10.3389/fphar.2021.559368
  • Low KL, Williams A, Manias E, Crawford K. Interventions to improve medication adherence in adult kidney transplant recipients: a systematic review. Nephrology Dialysis. 2015;30(5):752-61. doi:10.1093/ndt/gfu204
  • Caroline S, Campos RN, Gustavo F, ve ark. Immunosuppressive adherence after kidney transplantation in adult patients treated at an outpatient clinic: a better practice implementation project. JBI Evid Implement. 2021;19:306-314. doi:10.1097/XEB.0000000000000262
  • Chisholm MA, Lance C, Williamson GM, Mulloy LL. Development and validation of the immunosuppressant therapy adherence instrument (ITAS). Patient Education and Counseling. 2004;59(2005):13-20.
  • Oh CK, BaeBang J, Kim SJ, HaHuh K. Improvement of medication adherence with simplified once-daily immunosuppressive regimen in stable kidney transplant recipients: A prospective cohort study. Asian Journal of Surgery. 2020;43(6):660-667. doi:10.1016/j.asjsur.2019.07.011
  • Vankova B, Ladova KM, Kubena AA, Maly J,  Sulkova SD. Immunosuppressive therapy related adherence, beliefs and self-management in kidney transplant outpatients. Patient Prefer Adherence. 2018;12:2605-2613. doi:10.2147/PPA.S184166
  • Daniela MS, Laura LR, Curtis M, ve ark. Transplant regimen adherence for kidney recipients by engaging information technologies (TAKE IT): Rationale and methods for a randomized controlled trial of a strategy to promote medication adherence among transplant recipients. Contemporary Clinical Trials. 2021;103:1551-7144. doi:10.1016/j.cct.2021.106294
  • Gustavsen MT, Midtvedt K, Lonning K, ve ark. Evaluation of tools for annual capture of adherence to immunosuppressive medications after renal transplantation – a single‐centre open prospective trial. Transplant International. 2019;32:614-625. doi:10.1111/tri.13412
  • Ahram Han A, Min Sİ, Ahn, S, ve ark. Mobile medication manager application to improve adherence with immunosuppressive therapy in renal transplant recipients: A randomized controlled trial. PLoS ONE. 2019;14(11):e0224595. doi:10.1371/journal.pone.0224595
There are 30 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Research article
Authors

Naile Akıncı 0000-0002-7328-8610

Serkan Akinci 0000-0002-5213-5324

Publication Date June 1, 2022
Submission Date October 25, 2021
Acceptance Date February 24, 2022
Published in Issue Year 2022 Volume: 7 Issue: 2

Cite

AMA Akıncı N, Akinci S. Böbrek Nakli Yapılan Hastalarda Sosyo-Demografik ve Klinik Özelliklerin İmmünosupresif Uyumuna Etkisinin Değerlendirilmesi: Tek Merkezli Çalışma. OTJHS. June 2022;7(2):188-195. doi:10.26453/otjhs.999666

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