Medication Misuse, Nonadherence, and Clinical Outcomes Among Liver Transplant Recipients
| Autor: | Daniela P. Ladner, Michael Abecassis, Marina Serper, Rachel E. Patzer, Peter P. Reese, Rachel R. Koval, Michael S. Wolf, Kamila Przytula, Josh Levitsky |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Adult
Graft Rejection Male Pediatrics medicine.medical_specialty Health Knowledge Attitudes Practice Georgia Cross-sectional study medicine.medical_treatment Pilot Projects Intention Liver transplantation Rate ratio Article Medication Adherence Risk Factors Odds Ratio Medicine Humans Aged Chicago Transplantation Chi-Square Distribution Hepatology business.industry Drug Substitution Graft Survival Odds ratio Middle Aged Confidence interval Health Literacy Liver Transplantation Regimen Cross-Sectional Studies Treatment Outcome Multivariate Analysis Surgery Female Self Report business Comprehension Chi-squared distribution Immunosuppressive Agents |
| Popis: | Medication nonadherence after liver transplantation (LT) is associated with adverse clinical outcomes such as graft rejection and graft loss. Few studies have examined nonadherence and its impact on clinical outcomes in LT. The study objectives were (1) to evaluate medication understanding (with treatment knowledge and demonstrated regimen use scores) and medication adherence or nonadherence to entire regimens among LT recipients and (2) to examine associations of these exposures with clinical outcomes. We conducted a 2-site study of 105 recipients between 2011 and 2012 at 2 transplant centers in Chicago, IL and Atlanta, GA. Data were collected via detailed, in-person interviews and medical record reviews. Study participants were middle-aged and predominantly male; 15% of the sample had limited literacy. On average, patients were taking 11 medications [standard deviation (SD) = 4], and 39% had undergone a medication change within the last month. The average scores for the entire medication regimen were 86% (SD = 22%) for treatment knowledge and 78% (SD = 22%) for demonstrated regimen use. The mean score for self-reported nonadherence to the entire regimen was 14% (SD = 20%), whereas 32% of the patients were nonadherent according to tacrolimus levels. In multivariate analyses, lower income, less time since transplantation, a higher number of medications, and limited literacy were inversely associated with treatment knowledge scores (all P |
| Databáze: | OpenAIRE |
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