Effect of Immunosupressive Medication Adherence Using a SystemCHANGE Intervention: Case Study of a Turkish Kidney Transplant Recipient

Öz

In kidney transplant recipients, non-adherence to immunosuppressive medications leads to rejection, which negatively affects the function of the transplanted organ and increases mortality rates and healthcare costs. The purpose of this paper is to report a case from the parent study which is designed to test the efficacy of the SystemCHANGETM intervention compared to an attention-control intervention on medication adherence at 6 and 12 months in non-adherent Turkish adult kidney transplant recipients. This is a case report from the Turkish parent study which mirrored the methods of the Medication Adherence Given Individual Change (MAGIC) studies conducted with adult kidney transplant recipients that have been previously published. This study reports a case study of an adult kidney transplant recipient with poor medication adherence enrolled in an innovative six-month SystemCHANGETM intervention. Medication adherence increased immediately and was sustained throughout the intervention and maintenance phases. The SystemCHANGETM intervention resulted in immediate and sustained improvements in medication adherence. The patient experienced a clinically meaningful increase in MA (23%) by improving the timing of doses by linking them to a regularly occurring behavior. This is the first case study conducted in different culture, and the second case study on this topic in the international literature. The SystemCHANGETM intervention was effective in increasing medication adherence and quality of life in this individual.

Anahtar Kelimeler

• Medication adherence
• kidney transplantation
• SystemChange.

SistemDeğişimi Müdahalesinin İmmünosupresif İlaç Uyumunun Etkisi: Türk Bir Böbrek Nakli Alıcısının Olgu Çalışması

Öz

Böbrek nakli alıcılarında immünosupresif ilaçlara uyumsuzluk, nakledilen organın işlevini olumsuz etkileyen rejeksiyona yol açmakta ve ölüm oranları ile sağlık bakım maliyetlerini artırmaktadır. Bu makalenin amacı, SistemDeğişimiTM müdahalesinin uyumsuz Türk yetişkin böbrek nakli alıcılarında 6. ve 12. aylarda ilaç uyumu üzerinde bir dikkat kontrol müdahalesine kıyasla etkinliğini test etmek için tasarlanan ana çalışmadan bir vakayı bildirmektir. Bu çalışma, daha önce yayınlanmış olan yetişkin böbrek nakli alıcıları ile yürütülen Medication Adherence Given Individual Change (MAGIC) çalışmalarının yöntemlerini yansıtan Türk ebeveyn çalışmasından bir vaka raporudur. Bu çalışma, altı aylık yenilikçi bir SistemDeğişimiTM müdahalesine kaydolan, ilaç uyumu zayıf yetişkin bir böbrek nakli alıcısının vaka çalışmasını rapor etmektedir. İlaçlara bağlılık hemen artmış ve müdahale ve idame aşamaları boyunca sürdürülmüştür. SistemDeğişimiTM müdahalesi, ilaç uyumunda anında ve sürekli iyileşmelerle sonuçlanmıştır. Hasta, dozların zamanlamasını düzenli olarak gerçekleşen bir davranışa bağlayarak iyileştirerek ilaç uyumunda klinik olarak anlamlı bir artış (%23) yaşamıştır. Bu çalışma, farklı bir kültürde gerçekleştirilen ilk vaka çalışması ve uluslararası literatürde bu konuda yapılan ikinci vaka çalışmasıdır. SistemDeğişimiTM müdahalesi bu bireyde ilaç uyumunu ve yaşam kalitesini artırmada etkili olmuştur.

Anahtar Kelimeler

• İlaç uyumu
• böbrek nakli
• SistemDeğişimi

Kaynakça

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