Determinants of Medication Adherence in Liver Transplant Recipients.
ACR, Acute cellular Rejection
CAM, Complementary and Alternative Medicine
DDLT, Deceased Donor Liver Transplant
India
LDLT, Living Donor Liver Transplant
LT, liver transplantation
adherence
liver
transplant
Journal
Journal of clinical and experimental hepatology
ISSN: 0973-6883
Titre abrégé: J Clin Exp Hepatol
Pays: India
ID NLM: 101574137
Informations de publication
Date de publication:
Historique:
received:
22
08
2018
accepted:
07
03
2019
entrez:
1
1
2020
pubmed:
1
1
2020
medline:
1
1
2020
Statut:
ppublish
Résumé
The aim of this study was to study the determinants of nonadherence to immunosuppressant drugs in liver transplant (LT) recipients using personalised interview and questionnaire methods. The study was conducted on adult LT recipients (deceased donor liver transplant [DDLT] and living donor liver transplant [LDLT]) from the Indian subcontinent, at post-LT clinic visit between July and December 2016. Recipient details included baseline demography, comorbidity, psychological status, details of addiction, indication and type of transplant. Details on financial support for transplantation, admissions for rejection, infection and posttransplant complications were obtained from the hospital records. An adherence questionnaire was completed by direct interview and using a questionnaire. Sixty-seven LT recipients (56 males, median age 48.17 years) constituted the study group. Overall, 11 patients (16.47%) were nonadherent to treatment. LDLT recipients were more adherent than DDLT recipients. Nonadherent recipients were believers in alternative systems of medicine. Medication-related factors such as improper dosing, meagre drug knowledge difficulty in remembering drug dose and timings and economic constraints in continuing medical treatment were statistically significant in nonadherent recipients. Although variation in the tacrolimus levels were significantly more common in the nonadherent group, acute cellular rejection and infection were not statistically different. The prevalence of nonadherence was 16.5%. Determinants of nonadherence were DDLT, belief in alternative medications, high regimen complexity, poor knowledge about medications and cost issues with long-term medications.
Sections du résumé
BACKGROUND
BACKGROUND
The aim of this study was to study the determinants of nonadherence to immunosuppressant drugs in liver transplant (LT) recipients using personalised interview and questionnaire methods.
METHODS
METHODS
The study was conducted on adult LT recipients (deceased donor liver transplant [DDLT] and living donor liver transplant [LDLT]) from the Indian subcontinent, at post-LT clinic visit between July and December 2016. Recipient details included baseline demography, comorbidity, psychological status, details of addiction, indication and type of transplant. Details on financial support for transplantation, admissions for rejection, infection and posttransplant complications were obtained from the hospital records. An adherence questionnaire was completed by direct interview and using a questionnaire.
RESULTS
RESULTS
Sixty-seven LT recipients (56 males, median age 48.17 years) constituted the study group. Overall, 11 patients (16.47%) were nonadherent to treatment. LDLT recipients were more adherent than DDLT recipients. Nonadherent recipients were believers in alternative systems of medicine. Medication-related factors such as improper dosing, meagre drug knowledge difficulty in remembering drug dose and timings and economic constraints in continuing medical treatment were statistically significant in nonadherent recipients. Although variation in the tacrolimus levels were significantly more common in the nonadherent group, acute cellular rejection and infection were not statistically different.
CONCLUSIONS
CONCLUSIONS
The prevalence of nonadherence was 16.5%. Determinants of nonadherence were DDLT, belief in alternative medications, high regimen complexity, poor knowledge about medications and cost issues with long-term medications.
Identifiants
pubmed: 31889747
doi: 10.1016/j.jceh.2019.03.003
pii: S0973-6883(19)30064-7
pmc: PMC6926177
doi:
Types de publication
Journal Article
Langues
eng
Pagination
676-683Informations de copyright
© 2019 Indian National Association for Study of the Liver. Published by Elsevier B.V. All rights reserved.
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