Interventional pathways to improve long term outcome after heart transplantation (HTx) will be dependent on better understanding of behavioral and care system interventional pathways. The BRIGHT study is an unique intercontinental study in 11 countries, 36 HTx centers and 1397 patients to assess the variability in practice patterns in HTx long term follow-up as well as the prevalence and variability in non-adherence to health behaviors. The BRIGHT study assesses aspects of HTx care at different levels of the health care system (patient, health care provider/family, transplant center, health policy/health care system). Multilevel factors related to medication non-adherence were therefore also assessed for the 1st time..
Targets:
1. To describe chronic illness management practice patterns among centers, countries, and continents in heart transplantation.
2. To assess the prevalence and variability of non-adherence to treatment regimens, i.e. medication taking, smoking cessation, diet keeping, alcohol consumption, physical activity, sun protection, and appointment keeping in heart transplant recipients among centers, countries, and continents.
3. To determine which multi-level factors are related to immunosuppressive medication adherence at the patient, provide, health care organization and health care system level
To benchmark participating centers, countries, and continents in relation to chronic illness management practice patterns and non-adherence to health behaviors.
The study used a cross-sectional survey design in 36 heart transplant centers covering 11 countries in 4 continents. It used 4 questionnaires; 1 for the director of each heart transplant center, 1 for the clinicians at each center, and 2 for each heart transplant recipient (interview and self-administered), in addition to collecting clinical information on each heart transplant recipient and a collateral report by the clinicians on patients’ medication adherence.
The BRIGHT study’s findings will provide indication for leverage points to develop behavioral and care system interventional pathways to improve long term outcomes after HTx