Personality and Medication Adherence in Transplantation

移植中的个性和药物依从性

• 批准号: 6624104
• 负责人: CAROL S STILLEY
• 金额: $ 7.46万
• 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 2007-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6624104
• 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 申请小额拨款。坚持服用免疫抑制药 心胸移植(TXP)后的长期生存至关重要 存活率高，这对相当大比例的接受者来说是个问题。 心胸外科TXP。是一个拯救生命的过程，尽管代价高昂；坚持是， 因此，一个重要的公共卫生保健问题。心后依从性差 和/或肺TXP。占移植物死亡的很大比例 失败；从有限的捐赠者池中再次移植往往是唯一的 选项，而且不是非常成功。虽然在以下方面取得了一些进展 确定不遵守的心理社会预测因素，跨研究结果 一直是不一致的。我们认为，个性特征将为 更好地了解遵从性不佳的风险，因此可能会为设计提供信息 更有效的干预措施，以最大限度地遵守。鉴于……的缺乏 关于人格在TXP中的作用的实证工作，建议进行先导研究 旨在评估人格、药物之间的关系 遵从性和其他假定的风险因素，导致在 心胸外科TXP纵向研究。将被跟踪的收件人 在他们最初的18个月里。后TXP时代。拟议的研究是对一项 关于坚持性、生活质量和情绪的更大规模的持续纵向研究 对这个人口的调整。176名受试者的预计样本将是 从父母研究的参与者中招募；人格特征和 人格障碍的存在将在建议的 研究人员使用NEO-R和人格人际关系问卷， 分别在3-4个月。后TxP；所有其他数据将在 家长研究。依从性的心理社会预测因子(个人内和 上下文)以2个月为单位进行测量。后TXP时代。具体地说，服药依从性 进行评估(通过面谈、自我报告、实验室数据和电子 TxP后6、12和18个月)，我们将调查 人格与后续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 和一致性；我们的数据分析将考虑描述性和双变量 这些影响的关联性和多变量模型。建议的目标是 这项研究旨在为临床医生提供经验数据，以更好地识别TXP 面临不依从性风险的患者，以便a)为他们提供一种方法 需要心理/精神科转介的目标患者和b)设计更多 有效、经济的干预措施，最大限度地遵守TXP后的要求。 药物治疗方案。作为一个相对较新的研究人员，其目标是获得 为开展更广泛的心理因素研究提供经验 更好地解释和预测器官移植后的治疗依从性 移植。