Personality and Medication Adherence in Transplantation

移植中的个性和药物依从性

• 批准号: 6472388
• 负责人: CAROL S STILLEY
• 金额: $ 7.48万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2002
• 资助国家: 美国
• 起止时间: 2002-04-01 至 2004-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6472388
• 关键词: artificial immunosuppression; behavioral /social science research tag; clinical research; heart transplantation; human data; human subject; immunosuppressive; longitudinal human study; lung transplantation; mental health epidemiology; model design /development; personality; personality disorders; psychological models; questionnaires; statistics /biometry; therapy compliance

DESCRIPTION (provided by the applicant): This is a resubmission of our application for a small grant. Adherence with immunosuppressant medication following cardiothoracic transplantation (txp) is critical to long term survival and is problematic for a significant percentage of recipients. Cardiothoracic txp. is a life saving, though costly procedure; adherence is, therefore, an important public health care issue. Poor adherence after heart and/or lung txp. accounts for a significant proportion of mortality from graft failure; retransplantation, from a limited donor pool, is often the only option, and is not highly successful. While some progress has been made in identifying psychosocial predictors of non-adherence, findings across studies have been inconsistent. We propose that personality traits will provide keys to better understanding risk for poor adherence and may, therefore, inform design of more effective interventions to maximize compliance. Given the dearth of empirical work on the role of personality in txp, the proposed pilot research is designed to evaluate relationships between personality, medication adherence, and other putative risk factors for poor adherence within a longitudinal study of cardiothoracic txp. recipients who will be followed during their first 18 mos. post-txp. The proposed study is ancillary to a larger ongoing longitudinal study of adherence, quality of life, and emotional adjustment in this population. A projected sample of 176 subjects will be recruited from participants in the parent study; personality traits and the presence of personality disorder will be measured once in the proposed research, with the NEO--R and the Interpersonal Inventory of Personality, respectively, at 3-4 mos. post-txp; all other data will be collected in the parent study. Psychosocial predictors of adherence (intrapersonal and contextual) are measured at 2 mos. post-txp. Specifically, medication adherence is evaluated (with interview, self report, laboratory data, and electronic medication caps) at 6, 12, and 18 months post txp., and we will investigate prospective relationships between personality and subsequent adherence and the moderating effects of personality on the linkage between psychosocial variables and adherence; our data analyses will consider descriptive and bivariate associations and multivariate models of those effects. The goal of the proposed study is to provide clinicians with empirical data to better identify txp patients at risk of nonadherence in order to a) provide a way for them to target patients needing psychological/psychiatric referral and b) design more effective, economical interventions to maximize adherence with post-txp. medication regimes. The goal of the, a relatively new researcher, is to gain experience in order to develop more extensive study of psychological factors which better explain and predict treatment adherence after organ transplantation.

描述（由申请人提供）：这是我们的重新提交 申请小额补助金。免疫抑制药物依从性 心胸移植（TXP）后， 存活，并且对于相当大比例的接受者是有问题的。 心胸血栓形成。是一个拯救生命的过程，尽管代价高昂;坚持是， 因此，这是一个重要的公共卫生问题。心脏术后依从性差 和/或肺TXP。占移植死亡率的很大比例 失败;再次移植，从有限的供体库，往往是唯一的 选择，并不成功。虽然在这方面取得了一些进展， 确定不依从的社会心理预测因素，研究结果 一直不一致。我们认为，人格特质将提供关键， 更好地了解依从性差的风险，因此可以为设计提供信息 采取更有效的干预措施，以最大限度地提高合规性。鉴于缺乏 实证工作的作用，个性在TXP，建议试点研究 旨在评估人格，药物治疗 依从性，以及其他假定的依从性差的风险因素， 心胸血栓形成的纵向研究将被跟踪的收件人 在他们的前18个月。血栓形成后。拟议的研究是对一项 一项更大规模的正在进行的关于依从性、生活质量和情绪的纵向研究。 在这个人群中调整。预计样本为176名受试者， 从父母研究的参与者中招募;人格特质和 人格障碍的存在将被测量一次，在拟议的 研究，与NEO-R和人际人格量表， 分别在3-4个月。TXP后;所有其他数据将在 家长研究依从性的社会心理预测因素（自我和 上下文）在2个月时测量。血栓形成后。具体来说，药物依从性 评估（通过访谈、自我报告、实验室数据和电子 药物帽），在TXP后6、12和18个月，我们会调查 人格和随后的依从性之间的预期关系， 人格对心理社会变量之间联系的调节作用 我们的数据分析将考虑描述性和双变量 关联和这些影响的多变量模型。建议的目标 研究旨在为临床医生提供经验数据，以更好地识别TXP 有不依从风险的患者，以便a）为他们提供一种方法， 目标患者需要心理/精神转诊和B）设计更多 有效、经济的干预措施，以最大限度地坚持TXP后治疗。 药物制度。作为一个相对较新的研究人员， 经验，以便开展更广泛的心理因素研究 更好地解释和预测器官移植后的治疗依从性 移植