Adherence to medical recommendations and transition to adult services in pediatric transplant recipients.
Adherence to medical recommendations and transition to adult services in pediatric transplant recipients.
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DOI：
10.1097/mot.0b013e32833984a5
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发表时间：
2010-06
影响因子：
2.2
通讯作者：
Kerkar N
中科院分区：
文献类型：
--
作者：
Shemesh E;Annunziato RA;Arnon R;Miloh T;Kerkar N
不遵守治疗建议，特别是当与过渡到成人护理提供者，帐户，根据一些估计，大多数器官排斥反应和死亡的长期儿童生存的实体器官移植。因此，供应商必须熟悉与这些主要风险有关的问题和解决这些问题的方法。通过使用几种可用且经验证的监测方法之一来常规测量药物依从性是可能的，也是重要的。有许多方法可以提高依从性，实际上可以提高依从性，从而提高移植环境中的结果。向成人服务的过渡是一个脆弱的时期。作者认为，这是可能的，以改善过渡过程中，并提出建议，在此审查。然而，对改善过渡的干预措施的扎实研究非常缺乏。不遵守医疗建议是普遍存在的，并导致不良后果后，否则成功的儿科移植。一个特别脆弱的时期是接受者过渡到成人护理的时期。常规监测依从性，评估和解决依从性障碍，以及协作性，多学科护理都有望大大提高依从性并降低与过渡相关的风险。
Nonadherence to treatment recommendations, especially when associated with transition to adult care providers, account, by some estimates, for most organ rejections and death in long-term pediatric survivors of solid organ transplantations. It is therefore imperatives that providers become familiar with the issues related to those major risks and ways to address them. It is possible, and important, to routinely measure adherence to medications by using one of several available and proven methods of surveillance. There are numerous ways to improve adherence, and it is in fact possible to improve adherence and therefore outcomes in the transplant setting. The transition to adult services is a vulnerable period. The authors believe that it is possible to improve the transition process, and suggestions are presented in this review. However, solid research into interventions to improve transition is sorely lacking. Nonadherence to medical recommendations is prevalent and leads to poor outcomes following otherwise successful pediatric transplantation. An especially vulnerable period is the time when a recipient transitions to adult care. Routine monitoring of adherence, evaluating and addressing barriers to adherence, and collaborative, multidisciplinary care are all expected to substantially improve adherence and reduce the risks associated with transition.