Adherence and medical outcomes in pediatric liver transplant recipients who transition to adult services
Adherence and medical outcomes in pediatric liver transplant recipients who transition to adult services
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DOI：
10.1111/j.1399-3046.2007.00689.x
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发表时间：
2007-09-01
影响因子：
1.3
通讯作者：
Shemesh, Eyal
中科院分区：
文献类型：
--
作者：
Annunziato, Rachel A.;Emre, Sukru;Shemesh, Eyal
在青少年移植受者中，不坚持药物治疗与糟糕的医疗结果有关。目前尚不清楚，当移植受者过渡到成人医疗保健系统时，不遵守原则是否会进一步受到影响。本研究的目的是考察依从性在转变过程中是否发生变化。我们回顾了14名最近过渡的患者的医疗记录，并比较了他们在过渡前后的依从性和相应的医疗结果。这些结果也与只接受儿科或成人服务的两组患者进行了比较。所有患者的服药依从性通过使用他克莫司血药浓度的标准差来衡量。我们发现过渡后他克莫司的依从性显著降低。在过渡后，随着时间的推移，患者表现出比其他两个队列中的患者更差的依从性。这项小规模的回顾研究表明，从儿科移植诊所到成人移植诊所的过渡期是一个脆弱的时期。在就干预措施提出建议之前，有必要对过渡进程进行更大规模的前瞻性调查。
Non-adherence to medications is associated with poor medical outcomes in adolescent transplant recipients. It is unclear whether non-adherence is further compromised when transplant recipients transition to the adult health care system. The purpose of the present study was to examine whether adherence changes during transition. We reviewed the medical records of 14 recently transitioned patients and compared their adherence and corresponding medical outcomes before and after transition. These outcomes were also compared with two cohorts of patients receiving care solely in pediatric or adult services. Medication adherence, measured through the use of standard deviations of tacrolimus blood levels, was examined for all patients. We found that adherence to tacrolimus significantly decreased after transition. After transitioning, patients furthermore exhibited poorer adherence than patients in the other two cohorts did over time. This small retrospective study suggests that the period of transition from pediatric to adult transplant clinics is a vulnerable one. Larger, prospective investigations of the transition process are necessary before recommendations are made regarding interventions.