Immunosuppressant treatment adherence, barriers to adherence and quality of life in renal and liver transplant recipients in Spain
Immunosuppressant treatment adherence, barriers to adherence and quality of life in renal and liver transplant recipients in Spain
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DOI：
10.1111/j.1399-0012.2011.01544.x
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发表时间：
2012-03-01
影响因子：
2.1
通讯作者：
Lazaro, Pablo
中科院分区：
文献类型：
--
作者：
Morales, Jose M.;Varo, Evaristo;Lazaro, Pablo
为了评估接受肾移植(RT)或肝移植(LT)的患者对免疫抑制治疗(IST)的依从性以及影响IST依从性和生活质量(QOL)的感知障碍，西班牙向9000多名接受RT和LT的患者发送了一份问卷。问卷包括患者的社会人口学、器官移植和用药特征；IST依从性和患者对依从性的感知障碍；以及患者使用EuroQol的生活质量。对1983例RT患者和1479例LT患者的资料进行分析。RT(92.6%)和LT(88.5%)受者自我报告的IST依从性较高。在约25%的移植受者中，每日药物摄入量(平均每人每天2-3剂)被认为是一种生活方式限制，超过30%的RT和LT患者认为最常见的坚持障碍。总体而言，与低强度治疗方案相比，高强度治疗方案与较差的生活质量(EuroQol<；70)相关。大多数RT(71.0%)和LT(61.4%)患者在有能力的情况下更愿意抑制晚上的剂量。尽管在西班牙的这项首次大规模调查中，RT和LT患者对IST的依从率很高，但通过减少剂量频率来调整每日治疗强度可能是一种适当的策略，可以将坚持治疗的障碍降至最低，并提高生活质量。
To assess the adherence to immunosuppressant therapy (IST) and perceived barriers affecting IST adherence and quality of life (QOL) in patients who had received a renal (RT) or liver transplant (LT), a questionnaire was sent to over 9000 RT and LT recipients in Spain. Questionnaire comprised questions about patient's socio-demographic, organ transplant and medication characteristics; IST adherence and patient's perceived barriers to adherence; and patient's QOL using the EuroQol. Data from 1983 RT patients and 1479 LT patients were analyzed. Self-reported adherence to IST in RT (92.6%) and LT (88.5%) recipients was high. Daily medication intake (mean of 2-3 doses/d per patient) was considered a lifestyle restriction in about 25% of transplant recipients and was the most common barrier to adherence perceived by over 30% of RT and LT patients. Overall, high-intensity treatment regimens were associated with poorer QOL (EuroQol < 70) compared with low-intensity treatment regimens. Most RT (71.0%) and LT (61.4%) patients would prefer to suppress the evening dose if they were able to. Although high adherence rates to IST were reported in this first large Spanish survey in RT and LT patients, adjustment of daily treatment intensity by less frequent dosing may be an adequate strategy to minimize barriers to adherence and improve QOL.