TY - JOUR T1 - Böbrek Nakli Hastalarında İmmünosüpresan Tedaviye Uyum ve Hemşirenin Sorumlulukları AU - Tuncer, Metin AU - Khorshtd, Leyla PY - 2018 DA - January JF - Nefroloji Hemşireliği Dergisi JO - NefroHemDergi PB - Türk Nefroloji, Diyaliz ve Transplantasyon Hemşireleri Derneği WT - DergiPark SN - 2147-7728 SP - 26 EP - 31 VL - 13 IS - 1 LA - tr AB - Böbrek nakli hastaları, transplante edilen böbreğin sağlığının sürdürülmesi içinyaşam boyu immünosüpresif tedaviye (İT) ihtiyaç duymaktadır. İmmünosüpresiftedaviye uyumsuzluk oranları böbrek nakli yapılan hastalarda oldukça yüksektirve istenmeyen sonuçlara yol açmaktadır. İmmünosüpresif tedaviye uyumgöstermeyen hastalar, artmış mortalite ve morbidite, azalmış yaşam kalitesi vediyaliz tedavisine dönüş gibi sonuçlarla karşılaşabilmektedirler. Buna rağmenböbrek nakli hastalarında immünosüpresan tedaviye uyumsuzluk oranları %15-55arasında değişmektedir. Böbrek nakli hastalarının immünosüpresan tedaviyeuyumlarını; sosyoekonomik ve kültürel faktörler, hasta ilişkili faktörler, durumilişkili faktörler ve tedavi ilişkili faktörler etkileyebilmektedir. Böbrek naklihastalarının immünosüpresif tedaviye uyumunun artırılmasında hemşirelerin çokönemli görev ve sorumlulukları bulunmaktadır. Hemşireler immünosüpresantedaviye uyumu etkileyen faktörleri bilmeli ve doğru müdahaleleri planlamalıdır.Hemşireler, hastalara immünosüpresan ilaçlar konusunda eğitim ve danışmanlıkhizmeti vermeli, ev ziyaretleri düzenlemeli ve telefon görüşmeleri yapmalıdırlar.Hemşireler, hastalara uyumu artıran yöntemleri planlama konusunda destekolmalıdırlar. Bu makalede böbrek nakli yapılan hastalarda immünosüpresan grubuilaçlara uyum hakkında bilgi sunulmuştur. KW - İmmünosüpresif Tedavi KW - Böbrek Nakli KW - Tedaviye Uyum KW - Hemşirelik CR - 1. Cozzolino M, Galassi A, Pivari F, Ciceri P, Conte F. The Cardiovascular Burden in End-Stage Renal Disease. In: Ronco C, ed. Expanded Hemodialysis. 1st. Ed. Basel: Karger; 2017. P. 44-57. CR - 2. Abbasi MA, Chertow GM, Hall YN. End-stage renal disease. 15; 82(12): 1512. CR - 3. Marsicano EO, Fernandes NS, Colugnati FAB, Fernandes NMS, De Geest S et al. Multilevel correlates of nonadherence in kidney transplant patients benefitting from full cost coverage for immunosuppressives: a cross-sectional study. Plos One 2015; 10(11): 1-12. CR - 4. Mahendran AO, Barlow AD. Kidney transplantation. Surgery (Oxford) 2014; 32(7): 364-370. CR - 5. Schmid-Mohler G, Thut MP, Wüthrich RP, Denhaerynck K, De Geest S. Non-adherence to immunosuppressive medication in renal transplant recipients within the scope of the integrative model of behavioral prediction: a cross‐sectional study. Clinical Transplantation 2010; 24(2): 213-222. CR - 6. Lalić J, Veličković-Radovanović R, Mitić B, Paunović G, Cvetković T. Immunosuppressive medication adherence in kidney transplant patients. Medical Principles and Practice 2014; 23(4): 351-356. CR - 7. Chisholm MA. Issues of adherence to immunosuppressant therapy after solid-organ transplantation. Drugs 2002; 62(4): 567-575. CR - 8. Morrissey PE, Flynn ML, Lin S. Medication noncompliance and its implications in transplant recipients. Drugs 2007; 67(10): 1463-1481. CR - 9. Williams AF, Manias E, Gaskin CJ, Crawford K. Medicine non-adherence in kidney transplantation. Journal of Renal Care 2014; 40(2): 107-116. CR - 10. De Bleser L, Matteson M, Dobbels F, Russell C, De Geest S. Interventions to improve medication‐adherence after transplantation: a systematic review. Transplant International 2009; 22(8): 780-797. CR - 11. Laederach-Hofmann K, Bunzel B. Noncompliance in organ transplant recipients: a literature review. General Hospital Psychiatry 2000; 22(6): 412-424. CR - 12. Chisholm MA, Vollenweider LJ, Mulloy LL, Jagadeesan M, Wynn JJ et al. Renal transplant patient compliance with free immunosuppressive medications. Transplantation 2000; 70(8): 1240-1244. CR - 13. Gorevski E, Minkara A, Bain B, Mogilishetty G, Boone JM. (2011). PSU12 Immunosuppressant therapy adherence and rejection outcomes in liver and kidney transplant patients. Value in Health 2011; 14(3): A88. CR - 14. Denhaerynck K, Dobbels F, Cleemput I, Desmyttere A, Schäfer‐Keller P et al. Prevalence, consequences, and determinants of nonadherence in adult renal transplant patients: a literature review. Transplant International 2005; 18(10): 1121-1133. CR - 15. Butler JA, Roderick P, Mullee M, Mason JC, Peveler RC. Frequency and impact of nonadherence to immunosuppressants after renal transplantation: a systematic review. Transplantation 2004; 77(5): 769-776. CR - 16. 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. Journal of Investigative Medicine 2017; Oct; 65(7):1049-1056. CR - 17. Denhaerynck K, Steiger J, Bock A, Schäfer‐Keller P, Köfer S et al. Prevalence and risk factors of non‐adherence with immunosuppressive medication in kidney transplant patients. American Journal of Transplantation 2007; 7(1): 108-116. CR - 18. Gordon EJ, Prohaska TR, Gallant MP, Siminoff LA. Adherence to immunosuppression: a prospective diary study. In Transplantation Proceedings 2007; 39(10): 3081-3085. CR - 19. O'grady JG, Asderakis A, Bradley R, Burnapp L, McPake DM et al. Multidisciplinary insights into optimizing adherence after solid organ transplantation. Transplantation 2010; 89(5):627-632. CR - 20. De Geest S, Borgermans L, Gemoets H, Abraham I, Vlaminck H et al. Incidence, determinants, and consequences of subclinical noncompliance with immunosuppressive therapy in renal transplant recipients. Transplantation 1995; 59(3): 340-346. CR - 21. Dew MA, Di Martini AF, Dabbs ADV, Myaskovsky L, Steel J et al. Rates and risk factors for nonadherence to the medical regimen after adult solid organ transplantation. Transplantation 2007; 83(7): 858-873. CR - 22. Germani G, Lazzaro S, Gnoato F, Senzolo M, Borella V et al. Nonadherent behaviors after solid organ transplantation. In Transplantation Proceedings 2011; 43(1): 318-323. CR - 23. Dharancy S, Giral M, Tetaz R, Fatras M, Dubel L et al. Adherence with immunosuppressive treatment after transplantation: results from the French trial PREDICT. Clinical Transplantation 2012; 26(3): 293-299. CR - 24. Hugon A, Roustit M, Lehmann A, Saint-Raymond C, Borrel E et al. Influence of intention to adhere, beliefs and satisfaction about medicines on adherence in solid organ transplant recipients. Transplantation 2014; 98(2): 222-228. CR - 25. Gonçalves PRC, Reveles AF, Martins HIF, Rodrigues IL, Rodrigues SMM. Adherence to immunosuppressive therapy in kidney transplant recipients: Integrative Literature Review/A Adesão à Terapêutica Imunossupressora na Pessoa Transplantada Renal: Revisão Integrativa da Literatura/La Adhesión a la Terapia Inmunosupresora en el Paciente con Trasplante Renal: Revisión Integradora de la Literatura. Revista de Enfermagem Referência 2016; 4(8): 121. CR - 26. De Geest S, Sabaté E. (2003). Adherence to long-term therapies: evidence for action. European Journal of Cardiovascular Nursing 2003; 2(4): 323-323. CR - 27. Fredericks EM, Magee JC, Opipari‐Arrigan L, Shieck V, Well A et al. (2008). Adherence and health‐related quality of life in adolescent liver transplant recipients. Pediatric Transplantation 2008; 12(3): 289-299. CR - 28. Muduma G, Shupo FC, Dam S, Hawken NA, Aballéa S et al. Patient survey to identify reasons for non-adherence and elicitation of quality of life concepts associated with immunosuppressant therapy in kidney transplant recipients. Patient Preference and Adherence 2016; 10: 27-36. CR - 29. Griva K, Davenport A, Harrison M, Newman SP. Non-adherence to immunosuppressive medications in kidney transplantation: intent vs. forgetfulness and clinical markers of medication intake. Annals of Behavioral Medicine 2012; 44(1): 85-93. CR - 30. Pinsky BW, Takemoto SK, Lentine KL, Burroughs TE, Schnitzler MA et al. Transplant outcomes and economic costs associated with patient noncompliance to immunosuppression. American Journal of Transplantation 2009; 9(11): 2597- 2606. CR - 31. Moors-Tielen M. (2016). Psychosocial aspects of medication nonadherence after kidney transplantation. CR - 32. Chisholm‐Burns M, Pinsky B, Parker G, Johnson P, Arcona S et al. (2012). Factors related to immunosuppressant medication adherence in renal transplant recipients. Clinical Transplantation 2012; 26(5): 706-713. CR - 33. Tielen M, Jedeloo S, van Staa AL, Weimar W. Immunosuppressive drugs and young adults: a difficult combination. In: Weimar W, ed. Organ Transplantation: Ethical, Legal and Psychosocial Aspects towards a Common European Policy. 1st ed. Rotterdam: 2008. P. 563-569. CR - 34. Frazier PA, Davis-Ali SH, Dahl KE. Correlates of noncompliance among renal transplant recipients. Clinical Transplantation 1994; 8(6): 550-557. CR - 35. Hamedan MS, Aliha JM. Relationship between immunosuppressive medications adherence and quality of life and some patient factors in renal transplant patients in Iran. Global Journal of Health Science 2014; 6(4): 205. CR - 36. Cukor D, Rosenthal DS, Jindal RM, Brown CD, Kimmel PL. Depression is an important contributor to low medication adherence in hemodialyzed patients and transplant recipients. Kidney International 2009; 75(11): 1223-1229. CR - 37. Greenstein S, Siegal B. Compliance and noncompliance in patients with a functioning renal transplant: A Multicenter Study1, 2. Transplantation 1998; 66(12): 1718-1726. CR - 38. Dobbels F, Damme‐Lombaert RV, Vanhaecke J, Geest SD. Growing pains: Non‐adherence with the immunosuppressive regimen in adolescent transplant recipients. Pediatric Transplantation 2005; 9(3): 381-390. CR - 39. Przytula K, Smith SG, Patzer R, Wolf MS, Serper M. Medication regimen complexity in kidney and liver transplant recipients. Transplantation 2014; 98(7): e73 - e74. CR - 40. van Boekel GA, Kerkhofs CH, Hilbrands LB. Treatment satisfaction in renal transplant patients taking tacrolimus once daily. Clinical Therapeutics 2013; 35(11): 1821-1829. CR - 41. Nevins TE, Robiner WN, Thomas W. Predictive patterns of early medication adherence in renal transplantation. Transplantation 2014; 98(8): 878. CR - 42. Russell C, Conn V, Ashbaugh C, Madsen R, Wakefield M et al. Taking immunosuppressive medications effectively (TIMELink): a pilot randomized controlled trial in adult kidney transplant recipients. Clinical Transplantation 2011;25(6): 864-870. UR - https://dergipark.org.tr/tr/pub/hemsire/issue//359480 L1 - https://dergipark.org.tr/tr/download/article-file/418871 ER -