Adherence to the medical regimen during the first two years after lung transplantation
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 1195054
Author(s) Dew, Mary Amanda; Dimartini, Andrea F; De Vito Dabbs, Annette; Zomak, Rachelle; De Geest, Sabina; Dobbels, Fabienne; Myaskovsky, Larissa; Switzer, Galen E; Unruh, Mark; Steel, Jennifer L; Kormos, Robert L; McCurry, Kenneth R
Author(s) at UniBasel De Geest, Sabina M.
Year 2008
Title Adherence to the medical regimen during the first two years after lung transplantation
Journal Transplantation
Volume 85
Number 2
Pages / Article-Number 193-202
Keywords adherence, lung transplantation, heart transplantation, risk factors
Abstract BACKGROUND: Despite the importance of adherence to the medical regimen for maximizing health after lung transplantation, no prospective studies report on rates or risk factors for nonadherence in this patient population. Whether adherence levels differ in lung versus other types of transplant recipients is unknown. METHODS: A total of 178 lung recipients and a comparison group of 126 heart recipients were enrolled. Adherence in nine areas was assessed in separate patient and family caregiver interviews 2, 7, 12, 18, and 24 months posttransplant. Potential risk factors for nonadherence were obtained at the initial assessment. RESULTS: Cumulative incidence rates of persistent nonadherence (i.e., nonadherence at > or =2 consecutive assessments) were significantly lower (P<0.05) in lung recipients than heart recipients for taking immunosuppressants (13% nonadherent vs. 21%, respectively), diet (34% vs. 56%), and smoking (1% vs. 8%). Lung recipients had significantly higher persistent nonadherence to completing blood work (28% vs. 17%) and monitoring blood pressure (70% vs. 59%). They had a high rate of spirometry nonadherence (62%; not measured in heart recipients). The groups did not differ in nonadherence to attending clinic appointments (27%), exercise (44%), or alcohol limitations (7%). In both groups, poor caregiver support and having only public insurance (e.g., Medicaid) increased nonadherence risk in all areas. CONCLUSIONS: Lung recipients were neither uniformly better nor worse than heart recipients in adhering to their regimen. Lung recipients have particular difficulty with some home monitoring activities. Strategies to maximize adherence in both groups should build on caregiver support and on strengthening financial resources for patient healthcare requirements.
Publisher Lippincott Williams & Wilkins
ISSN/ISBN 0041-1337
Full Text on edoc No
Digital Object Identifier DOI 10.1097/TP.0b013e318160135f
PubMed ID
ISI-Number WOS:000252654100006
Document type (ISI) Journal Article

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