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成年肾移植患者中特定替代和补充医学的患病率及其相关因素。

Prevalence and correlates of selected alternative and complementary medicine in adult renal transplant patients.

作者信息

Hess Sascha, De Geest Sabina, Halter Klaus, Dickenmann Michael, Denhaerynck Kris

机构信息

Institute of Nursing Science, University of Basel, Basel, Switzerland.

出版信息

Clin Transplant. 2009 Jan-Feb;23(1):56-62. doi: 10.1111/j.1399-0012.2008.00901.x. Epub 2008 Sep 11.

Abstract

BACKGROUND/SIGNIFICANCE: The use of complementary and alternative medicine (CAM) has increased considerably in the general population in recent decades. However, the prevalence of CAM use in renal transplant patients has not yet been assessed.

AIM

To determine the prevalence and correlates of CAM use among renal transplant patients (RTX) who are more than one year post transplant.

METHODS

This secondary data analysis used data from Part 1 of the Supporting Medication Adherence in Renal Transplantation (SMART) study, which tested prevalence, determinants and consequences of non-adherence regarding immunosuppressive medication in kidney transplant (renal TX) patients. The study's convenience sample consisted of 356 patients recruited from two Swiss outpatient transplant clinics during their annual examination visits (mean age: 53+/-13; male: 58%). The use of CAM as well as the specific kind of CAM used was assessed through structured interviews. Assessed CAM use correlates were age, gender, education, depressive symptomatology, comorbidity and smoking status. Relationships between CAM use and candidate correlates were explored using multiple logistic regression.

RESULTS

The prevalence of CAM use in this sample of renal TX patients was 11.8%. Most frequently used alternative medicines were Homeopathy (42.9%) and Chinese medicine (23.8%). Two patients used St John's wort. The percentage of patients using Homeopathy (5.1%) and herbal medicine (2%) was similar to that of the general Swiss population (HO: 6.1% & HM: 2.6%). Significant correlates for CAM use were younger age (p=0.017; OR=0.96; 95%CI=0.93-0.99) and female gender (p=0.035; OR=2.13; 95%CI=1.05-4.3).

CONCLUSION

Every eighth renal transplant recipient in this sample used some form of CAM. Of these, some used herbal medicines, of which some are known to interfere with certain immunosuppressive treatment (St John's wort/Chinese medicines). These findings indicate that it is important for health care providers working in renal TX to assess CAM use.

摘要

背景/意义:近几十年来,补充和替代医学(CAM)在普通人群中的使用显著增加。然而,肾移植患者中使用CAM的患病率尚未得到评估。

目的

确定移植后一年以上的肾移植患者(RTX)中使用CAM的患病率及其相关因素。

方法

这项二次数据分析使用了肾移植支持药物依从性(SMART)研究第一部分的数据,该研究测试了肾移植(肾TX)患者免疫抑制药物不依从的患病率、决定因素和后果。该研究的便利样本包括从瑞士两家门诊移植诊所年度检查就诊时招募的356名患者(平均年龄:53±13岁;男性:58%)。通过结构化访谈评估CAM的使用情况以及所使用的CAM的具体类型。评估的CAM使用相关因素包括年龄、性别、教育程度、抑郁症状、合并症和吸烟状况。使用多元逻辑回归探讨CAM使用与候选相关因素之间的关系。

结果

该肾TX患者样本中使用CAM的患病率为11.8%。最常用的替代药物是顺势疗法(42.9%)和中药(23.8%)。两名患者使用了圣约翰草。使用顺势疗法(5.1%)和草药(2%)的患者百分比与瑞士普通人群相似(顺势疗法:6.1% & 草药:2.6%)。CAM使用的显著相关因素是年龄较小(p = 0.017;OR = 0.96;95%CI = 0.93 - 0.99)和女性(p = 0.035;OR = 2.13;95%CI = 1.05 - 4.3)。

结论

该样本中每八名肾移植受者中就有一人使用某种形式的CAM。其中,一些人使用草药,其中一些已知会干扰某些免疫抑制治疗(圣约翰草/中药)。这些发现表明,从事肾TX工作的医疗保健提供者评估CAM的使用情况很重要。

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