Factors impacting the medication "Adherence Landscape" for transplant patients.
Factors impacting the medication "Adherence Landscape" for transplant patients.
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影响移植患者药物“依从性”的因素。
DOI：
10.1111/ctr.14962
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发表时间：
2023
影响因子：
2.1
通讯作者：
Levan,MaceyL
中科院分区：
文献类型：
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作者：
Bendersky,VictoriaA;Saha,Amrita;Sidoti,CarolynN;Ferzola,Alexander;Downey,Max;Ruck,JessicaM;Vanterpool,KarenB;Young,Lisa;Shegelman,Abigail;Segev,DorryL;Levan,MaceyL
药物不依从性导致移植后移植排斥和失败；然而，关于不依从性原因的有限知识阻碍了改善依从性的干预措施的发展。我们针对实体器官移植受者在移植药物自我管理过程中被忽视的挑战进行了焦点小组研究，并检查了他们对移植后药物治疗方案的依从性策略和看法。方法对31例成人移植受者进行4组研究。参与者在2014年至2019年期间在约翰霍普金斯医院接受了肾脏、肝脏或肝肾联合移植。对焦点小组进行录音和转录。采用恒值比较法对转录本进行归纳分析。结果调查结果大致分为两大类：(1)依从性障碍和(2)“依从性景观”。我们将前者定义为直接标记为参与者坚持治疗障碍的因素，将后者定义为严重影响移植后药物自我管理过程的因素。结论：我们建议改变医疗保健提供者和研究人员解决药物不依从性问题的方式。与其问为什么患者不坚持治疗，我们建议构建和理解患者的“依从性景观”将提供一种优化的方式来协调患者和提供者的目标，并提高健康结果。
BackgroundMedication non‐adherence contributes to post‐transplant graft rejection and failure; however, limited knowledge about the reasons for non‐adherence hinders the development of interventions to improve adherence. We conducted focus groups with solid organ transplant recipients regarding overlooked challenges in the process of transplant medication self‐management and examined their adherence strategies and perceptions towards the post‐transplant medication regimen.MethodsWe conducted four focus groups withn= 31 total adult transplant recipients. Participants had received kidney, liver, or combined liver/kidney transplant at Johns Hopkins Hospital between 2014 and 2019. Focus groups were audio‐recorded and transcribed. Transcripts were analyzed inductively, using the constant comparative method.ResultsResponses generally fell into two major categories: (1) barriers to adherence and (2) “adherence landscape”. We define the former as factors directly labeled as barriers to adherence by participants and the latter as factors that heavily influence the post‐transplant medication self‐management process.ConclusionsWe propose a shift in the way healthcare providers and researchers, address the question of medication non‐adherence. Rather than asking why patients are non‐adherent, we suggest that constructing and understanding patients’ “adherence landscape” will provide an optimal way to align the goals of patients and providers and boost health outcomes.