PURPOSE OF REVIEW: Nonadherence to treatment recommendations, especially when associated with transition to adult care providers, account, by some estimates, for most organ rejections and death in long-term pediatric survivors of solid organ transplantations. It is therefore imperative that providers become familiar with the issues related to those major risks and ways to address them. RECENT FINDINGS: It is possible, and important, to routinely measure adherence to medications by using one of several available and proven methods of surveillance. There are numerous ways to improve adherence, and it is in fact possible to improve adherence and therefore outcomes in the transplant setting. The transition to adult services is a vulnerable period. The authors believe that it is possible to improve the transition process, and suggestions are presented in this review. However, solid research into interventions to improve transition is lacking. SUMMARY: Nonadherence to medical recommendations is prevalent and leads to poor outcomes following otherwise successful pediatric transplantation. An especially vulnerable period is the time when a recipient transitions to adult care. Routine monitoring of adherence, evaluating and addressing barriers to adherence, and collaborative, multidisciplinary care are all expected to substantially improve adherence and reduce the risks associated with transition.
PURPOSE OF REVIEW: Nonadherence to treatment recommendations, especially when associated with transition to adult care providers, account, by some estimates, for most organ rejections and death in long-term pediatric survivors of solid organ transplantations. It is therefore imperative that providers become familiar with the issues related to those major risks and ways to address them. RECENT FINDINGS: It is possible, and important, to routinely measure adherence to medications by using one of several available and proven methods of surveillance. There are numerous ways to improve adherence, and it is in fact possible to improve adherence and therefore outcomes in the transplant setting. The transition to adult services is a vulnerable period. The authors believe that it is possible to improve the transition process, and suggestions are presented in this review. However, solid research into interventions to improve transition is lacking. SUMMARY: Nonadherence to medical recommendations is prevalent and leads to poor outcomes following otherwise successful pediatric transplantation. An especially vulnerable period is the time when a recipient transitions to adult care. Routine monitoring of adherence, evaluating and addressing barriers to adherence, and collaborative, multidisciplinary care are all expected to substantially improve adherence and reduce the risks associated with transition.
Authors: Lili Penkower; Mary Amanda Dew; Demetrius Ellis; Susan M Sereika; Julius M M Kitutu; Ron Shapiro Journal: Am J Transplant Date: 2003-11 Impact factor: 8.086
Authors: S Kipps; T Bahu; K Ong; F M Ackland; R S Brown; C T Fox; N K Griffin; A H Knight; N P Mann; H A W Neil; H Simpson; J A Edge; D B Dunger Journal: Diabet Med Date: 2002-08 Impact factor: 4.359
Authors: Graham J Reid; M Jane Irvine; Brian W McCrindle; Renee Sananes; Paul G Ritvo; Samuel C Siu; Gary D Webb Journal: Pediatrics Date: 2004-03 Impact factor: 7.124
Authors: Eyal Shemesh; Benjamin L Shneider; Jill K Savitzky; Lindsay Arnott; Gabriel E Gondolesi; Nancy R Krieger; Nanda Kerkar; Margret S Magid; Margaret L Stuber; James Schmeidler; Rachel Yehuda; Sukru Emre Journal: Pediatrics Date: 2004-04 Impact factor: 7.124
Authors: Sarah B Cairo; Indrajit Majumdar; Aurora Pryor; Alan Posner; Carroll M Harmon; David H Rothstein Journal: Obes Surg Date: 2018-04 Impact factor: 4.129