A Pilot Randomized Controlled Trial to Promote Immunosuppressant Adherence in Adult Kidney Transplant Recipients.
| Autor: | Cukor D; Department of Psychiatry and Behavioral Science, SUNY Downstate Medical Center,Brooklyn, N.Y., USA., Ver Halen N, Pencille M, Tedla F, Salifu M |
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| Jazyk: | angličtina |
| Zdroj: | Nephron [Nephron] 2017; Vol. 135 (1), pp. 6-14. Date of Electronic Publication: 2016 Sep 07. |
| DOI: | 10.1159/000448627 |
| Abstrakt: | Background: Nonadherence to immunosuppressant medication is a prevalent practice among kidney transplant recipients and has been associated with increased risk for graft failure and economic burden. The aim of this pilot study was to test whether a culturally sensitive cognitive-behavioral adherence promotion program could significantly improve medication adherence to tacrolimus prescription as measured by telephone pill counts among kidney transplant recipients. Methods: Thirty-three adult transplant recipients were less than 98% adherent to tacrolimus prescription based on 3 telephone pill counts and were randomized either to the 2-session cognitive-behavioral adherence promotion program or to standard care. The curriculum was developed from an iterative process with transplant recipients into a 2-session group program that provided psychoeducation, addressed barriers to adherence, fostered motivation to improve adherence behavior, and discussed cultural messages on adherence behavior. Results: The intervention group displayed significantly higher levels of adherence when compared to the control group (t = 2.2, p = 0.04) and. similarly, when the amount of change was compared between the groups, the intervention group showed more change than the control condition (F (22,1) = 12.005, p = 0.003). Tacrolimus trough concentration levels were used as a secondary measure of adherence and, while there were no significant between-group differences for mean trough concentration levels, the variability in the trough levels did significantly decrease over time indicating more consistent pill-taking behavior in the intervention group. Conclusions: There is preliminary support for the pilot program as a successful intervention in helping patients with their immunosuppressant medication. (© 2016 S. Karger AG, Basel.) |
| Databáze: | MEDLINE |
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