Transplantasyon Hastalarında İmmünosüpresif Tedaviye Uyumun Değerlendirilmesi

Yıl 2024, Cilt: 9 Sayı: 1, 77 - 92, 31.03.2024

Ayşe Gül Atay Doyğacı , Sevil Güler

https://doi.org/10.25279/sak.1065784

Öz

Giriş: Transplantasyon sonrası dönemde hastalarda rejeksiyonun önlenmesi için immünosüpresif ilaçları düzenli ve doğru bir şekilde yaşamları boyunca kullanmaları gerekmektedir.
Amaç: Bu çalışma böbrek, karaciğer ve kalp nakli yapılan hastalarda immünosüpresif tedaviye uyumu belirlemek amacıyla tanımlayıcı olarak yapıldı.
Gereç ve Yöntem: Araştırmanın örneklemini bir vakıf üniversitesi hastanesinde böbrek, karaciğer ve kalp nakli ve takipleri yapılan 60 hasta oluşturdu. Veriler, transplantasyon hastaları ile yüz yüze görüşülerek toplanmıştır. Hastaların kullandıkları immünosüpresif ilaçlar, hastane kayıtlarından karşılaştırıldı ve immünosüpresif tedavi planına uyumları belirlendi. Verilerin değerlendirilmesinde tanımlayıcı istatistikler, Spearman korelasyon katsayısı, Ki-kare ve Fisher Exact testleri kullanıldı.
Bulgular: Çalışmada hastaların %46.7'sine böbrek nakli, %36.7'sine karaciğer nakli, %13.3'üne kalp nakli ve %3.3'üne eş zamanlı böbrek-karaciğer nakli yapıldı. Tüm hastalara immünosüpresif tedavi uygulandı ve tedaviye uyum oranı %86.7 idi. Toplam immünosüpresif ilaç sayısı ile tedavi planına uygun kullanılan ilaç sayısı arasında anlamlı pozitif korelasyon bulundu (p<0.001). Hastaların tamamı düzenli olarak immünosüpresif ilaç kullanmaktaydı, %40.0'ında düzenli ilaç kullanımını etkileyen faktörler vardı ve ilk iki faktör immünosüpresif ilaç kullanmayı unutma (%70.8) ve uygun olmayan ilaç saatleri (%25.0) idi.
Sonuç: Sonuçlar, hastaların transplantasyon sonrası dönemde immünosüpresif tedaviye uyum ve uyumsuzluk faktörleri açısından düzenli olarak değerlendirilmesi gerektiğini göstermiştir. Hasta ve yakınlarına uyumu artırmak için programlar geliştirilmeli, eğitim ve danışmanlık verilmelidir.

Anahtar Kelimeler

Uyum, Kalp Nakli, İmmünosupresif Tedavi, Böbrek Nakli, Karaciğer Nakli

Assessment of Immunosuppressive Therapy Adherence in Transplantation Patients

Öz

Introduction: In the post-transplant period, patients should use immunosuppressive drugs regularly and correctly throughout their lives to prevent rejection.
Objectives: This descriptive study was conducted to determine adherence to immunosuppressive therapy in renal, liver and heart transplant patients.
Materials and Methods: The study sample consisted of 60 patients who underwent renal, liver, and heart transplantation and follow-up visits at a foundation university hospital. Data was collected by face-to-face interviews with transplantation patients. The immunosuppressive drugs used by the patients were compared from the hospital records and their compliance with the immunosuppressive treatment plan was determined. Descriptive statistics, Spearman correlation coefficient, Chi-squared, and Fisher Exact tests were used for data evaluation.
Results: In the study, renal transplantation was performed in 46.7% of the patients, liver transplantation in 36.7%, heart transplantation in 13.3%, and simultaneous renal-liver transplantation in 3.3%. All patients received immunosuppressive therapy and therapy adherence rate was 86.7%. A significant positive correlation was found between the total number of immunosuppressive drugs and the number of drugs used in line with the treatment plan (p<0.001). All patients had used immunosuppressive drugs regularly, 40.0% had the factors affecting regular drug use, and the first two factors were as follows: forgetting to use immunosuppressive drugs (70.8%), and inappropriate drug hours (25.0%).
Conclusion: The results showed that the patients should be evaluated regularly in terms of immunosuppressive therapy adherence and nonadherence factors in the post-transplantation period. Programs should be developed.

Anahtar Kelimeler

Adherence, Heart Transplantation, Immunosuppressive Therapy, Kidney Transplantation, Liver Transplantation.

Kaynakça

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