Department of Nephrology, Hospital Central Universitario de Asturias, Oviedo, Spain.
J Nephrol. 2013 Mar-Apr;26(2):297-305. doi: 10.5301/jn.5000132. Epub 2012 May 30.
The aim of this study was to analyze patient satisfaction and adherence in a sample of renal transplant patients living with a working allograft.
An epidemiological cross-sectional multicenter study was carried out with renal recipients who had received a transplant 6-24 months before and were undergoing immunosuppressant therapy (IT). Sociodemographic and clinical variables registered were dosage, allograft functioning, number of medications, health-related quality of life (HRQoL by SF-6D), patients' satisfaction (SAT-Q) and adherence to medication (abnormal levels of immunosuppressant in blood tests [ALIBT] and clinical impression). Relationships between those parameters were contrasted (chi-square test, Spearman correlation coefficient and Mann-Whitney U-test). Multivariate regression models (linear and logistic) were computed to analyze the factors related to patients' satisfaction and adherence to medication, respectively.
Data from 206 patients were collected (61.2% males with a mean age of 53.35 years). Nonadherence rates (29.1% and 31.1%) were found according to clinical impression and ALIBT, respectively (chi-square = 31.810, p<0.001). Overall, global patients' satisfaction (74.000 ± 1.251) and HRQoL (0.765 ± 0.011) levels were high. Low-moderate significant associations between satisfaction and adherence to IT and HRQoL were found (p<0.01). Finally, age, vitality, allograft functioning and dosage were correlated with patient satisfaction (R2=0.174; F(1,185)=4.134; p<0.043). Number of medications (odds ratio [OR] = 0.890; 95% confidence interval [95% CI], 0.812-0.975; p=0.012), convenience domain (OR=1.037; 95% CI, 1.005-1.070; p=0.021) and clinical criteria (OR=6.135; 95% CI, 2.945-12.782; p<0.001) were associated with adherence.
In renal transplant patients, satisfaction with IT is related to the levels of HRQoL and compliance.
本研究旨在分析一组移植肾功能正常的肾移植患者的满意度和依从性。
这是一项采用问卷调查法的前瞻性多中心研究，纳入了肾移植术后 6-24 个月且正在接受免疫抑制治疗的患者。登记的社会人口学和临床变量包括剂量、移植物功能、药物种类、健康相关生活质量（SF-6D 评分）、患者满意度（SAT-Q）和药物依从性（血液免疫抑制剂浓度异常[ALIBT]和临床印象）。对这些参数进行了对比（卡方检验、Spearman 相关系数和 Mann-Whitney U 检验）。分别使用多元线性和逻辑回归模型分析与患者满意度和药物依从性相关的因素。
共纳入 206 例患者（61.2%为男性，平均年龄为 53.35 岁）。根据临床印象和 ALIBT，不依从率分别为 29.1%和 31.1%（卡方=31.810，p<0.001）。总体而言，患者满意度（74.000±1.251）和健康相关生活质量（0.765±0.011）评分较高。患者满意度与免疫抑制治疗依从性和健康相关生活质量之间存在低度至中度显著相关性（p<0.01）。最后，年龄、活力、移植物功能和剂量与患者满意度相关（R2=0.174；F(1,185)=4.134；p<0.043）。药物种类（比值比[OR]=0.890；95%置信区间[95%CI]，0.812-0.975；p=0.012）、便利性（OR=1.037；95%CI，1.005-1.070；p=0.021）和临床标准（OR=6.135；95%CI，2.945-12.782；p<0.001）与依从性相关。
在肾移植患者中，对免疫抑制治疗的满意度与健康相关生活质量和依从性相关。
