Nora Drick1, Benjamin Seeliger1, Jan Fuge2, Igor Tudorache3, Mark Greer1,2, Tobias Welte1,2, Axel Haverich2,3, Jens Gottlieb1,2. 1. Department of Respiratory Medicine, Hannover Medical School, Hannover, Germany. 2. Member of the German Center for Lung Research (DZL), Biomedical Research in End-stage and Obstructive Lung Disease Hannover (BREATH), Hannover, Germany. 3. Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany.
Abstract
BACKGROUND: Non-adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non-adherence is difficult to assess, and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. METHODS: A single-center cross-sectional observational study of all LTx recipients attending our department between 07/2013 and 05/2014 was performed. Non-adherence was assessed using patient self-reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with healthcare worker (HCW) judgment and reasons for non-adherence by the Immunosuppressive Therapy Barriers Scale. RESULTS: A total of 138/504 patients (27.4%) self-reported non-adherence to immunosuppressive medication. HCW scored 96/504 patients (19.1%) as poorly adherent. Self-reported non-adherence increased with increasing interval after transplantation. The main reason for non-adherence was punctuality (75%), with only 11% reporting drug holidays. Explanations for non-adherence were primarily related to self-organization and difficulties incorporating medication into daily routine. There were no significant differences in medication knowledge or variation in trough levels. CONCLUSIONS: This study confirms that non-adherence in LTx recipients is frequent according to self-report. Barriers are self-organization and difficulties incorporating medication into daily routine. Social and behavioral support is needed to overcome non-adherence. (ClinicalTrials.gov number: NCT01889017).
BACKGROUND: Non-adherence to immunosuppressive treatment following solid organ transplantation is common and often associated with poorer outcomes. Non-adherence is difficult to assess, and barriers to adherence in lung transplant (LTx) recipients remain to be elucidated. METHODS: A single-center cross-sectional observational study of all LTx recipients attending our department between 07/2013 and 05/2014 was performed. Non-adherence was assessed using patient self-reporting, including Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS) along with healthcare worker (HCW) judgment and reasons for non-adherence by the Immunosuppressive Therapy Barriers Scale. RESULTS: A total of 138/504 patients (27.4%) self-reported non-adherence to immunosuppressive medication. HCW scored 96/504 patients (19.1%) as poorly adherent. Self-reported non-adherence increased with increasing interval after transplantation. The main reason for non-adherence was punctuality (75%), with only 11% reporting drug holidays. Explanations for non-adherence were primarily related to self-organization and difficulties incorporating medication into daily routine. There were no significant differences in medication knowledge or variation in trough levels. CONCLUSIONS: This study confirms that non-adherence in LTx recipients is frequent according to self-report. Barriers are self-organization and difficulties incorporating medication into daily routine. Social and behavioral support is needed to overcome non-adherence. (ClinicalTrials.gov number: NCT01889017).
Authors: Anna Bertram; Jan Fuge; Hendrik Suhling; Igor Tudorache; Axel Haverich; Tobias Welte; Jens Gottlieb Journal: PLoS One Date: 2019-12-17 Impact factor: 3.240
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