Differences in Patient and Transplant Professional Perceptions of Immunosuppression-Induced Cosmetic Side Effects
| Autor: | M. Roy First, John A. Gordon, Goran B. Klintmalm, Carl H. Kincaid, Kristin N. Spinola, Kevin J. Gorman, Mark I. Aeder, Gabriel M. Danovitch, John C. West, Thomas Peters |
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| Rok vydání: | 2004 |
| Předmět: |
Male
Hirsutism Pediatrics medicine.medical_specialty media_common.quotation_subject medicine.medical_treatment medicine Humans skin and connective tissue diseases Kidney transplantation hirsutism media_common Transplantation business.industry Communication Incidence (epidemiology) Alopecia Immunosuppression medicine.disease Kidney Transplantation Tacrolimus Surgery Feeling Gingival Hyperplasia Female Perception sense organs business Psychosocial Immunosuppressive Agents |
| Zdroj: | Transplantation. 78:537-543 |
| ISSN: | 0041-1337 |
| DOI: | 10.1097/01.tp.0000139253.30998.57 |
| Popis: | BACKGROUND A two-part study was initiated to compare kidney transplant patient and transplant professional perceptions regarding immunosuppression-related physical changes and their impact on transplant recipients. METHODS Parallel surveys were developed and administered to transplant patients and active transplant clinicians. RESULTS Eighty percent of surveyed patients reported immunosuppression-induced hirsutism, gingival hyperplasia, acne, alopecia, or cushingoid facies. Hirsutism (94%) and gingival hyperplasia (51%) occurred more frequently in cyclosporine patients (p < 0.01); alopecia (30%) occurred more frequently in tacrolimus patients (p < 0.01). Patient reported incidence of physical changes significantly exceeded observations by professionals for every condition (p < 0.01), however 84.4% of affected patients reported feeling "happy to endure" changes "for the sake of having a transplant." Patients also reported emotional and social effects due to physical changes, an outcome underestimated by transplant professionals (p < 0.01). Patients and professionals communicated about physical changes; however, more than half of affected patients believed communication occurred "rarely/never" while over half of the professionals believed communication occurred "every visit/most of the time." Although most physicians believed changes could be addressed, doctors recommended treatment for less than half of the affected patients. When recommended therapy changes were pursued, treatments were effective in the majority of cases. CONCLUSIONS Incidence of immunosuppression-related physical changes is high and somewhat dependent on drug regimen. Although patients seem willing to accept cosmetic changes for the sake of having a transplant, physical changes have a psychosocial impact that is underestimated by clinicians. Immunosuppression-related physical changes remain underaddressed; effective interventions offer opportunities for improved care. |
| Databáze: | OpenAIRE |
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