Adherence with immunosuppressive treatment after transplantation: results from the French trial PREDICT
Adherence with immunosuppressive treatment after transplantation: results from the French trial PREDICT
复制标题
DOI：
10.1111/j.1399-0012.2012.01652.x
复制
发表时间：
2012-05-01
影响因子：
2.1
通讯作者：
Pageaux, Georges-Philippe
中科院分区：
文献类型：
--
作者：
Dharancy, Sebastien;Giral, Magali;Pageaux, Georges-Philippe
虽然器官移植后的免疫抑制治疗对长期预后至关重要，但患者并不像预期的那样遵守免疫抑制治疗。在这项观察性研究中，入组了接受过肾脏或肝脏移植的患者。患者使用依从性评估测试和医生使用视觉模拟量表评估依从性。进行线性回归以确定依从性的决定因素。接受肾移植的患者（27%）比接受肝移植的患者（40%）更少自称是良好的依从者。医生和患者评估之间存在差异。在至少一个评估组（整个队列，肾肝移植组）中，良好依从性的发生率因性别、移植时年龄、再次移植和移植后时间的不同而存在显著差异。在所有三组中，依从性随着免疫抑制剂处方数量的增加而降低。在整个队列中，服用较少免疫抑制剂的患者的良好依从性率显著较高（1种免疫抑制剂为45%，3种免疫抑制剂为24%; p = 0.02）。在这项研究中，这是第一个在法国进行的研究，我们证实了免疫抑制剂治疗的依从性很低，更简单的治疗方案可能有利于依从性。
Although immunosuppressive therapy after organ transplantation is paramount for long-term outcomes, patients do not comply with their immunosuppressive treatment as much as might be expected. In this observational study, patients having undergone a kidney or liver transplantation were enrolled. Adherence was evaluated by patients using the compliance evaluation test and by physicians using a visual analogic scale. A linear regression was performed to identify determinants of adherence. Less patients having undergone kidney transplantation (27%) described themselves as good compliers than liver transplanted patients (40%). Discrepancy was noted between the physician and patient assessments. Rates of good adherence were significantly different depending on gender, age at transplantation, retransplantation, and time elapsed since transplantation, in at least one of the groups evaluated (whole cohort, kidney liver transplantation groups). In all three groups, adherence decreased with the number of immunosuppressants prescribed. In the whole cohort, the rate of good adherence was significantly higher in patients taking lower number of immunosuppressive drugs (45% for 1 vs. 24% for 3 immunosuppressants; p = 0.02). In this study, which is the first study of this scale in France, we confirmed that adherence with immunosuppressant treatment was low and that simpler treatment regimens may favor adherence.