Blanca Martínez Pérez A, López Suárez A, Rodríguez Rodríguez J, Sobrino Márquez J M, Lage Gallé E
UGC Cardiología y Cía. Vascular Hospital Juan Ramón Jiménez, Huelva, Spain.
Transplant Proc. 2013;45(10):3662-4. doi: 10.1016/j.transproceed.2013.11.006.
Heart transplant patients are required to take medication for life, both immunosuppressants to prevent rejection and any required for other illnesses. Treatment compliance can be measured quantitatively or qualitatively. Compliance measurement is not easy owing to different factors. The aim of this study was to assess the prevalence of therapeutic compliance in heart transplant patients.
We undertook a cross-sectional observational descriptive study. The sample comprised patients who received a heart transplant from 2001 to 2011. Of the 203 patients in total, we studied 99. We used the Morisky-Green test as an indirect method and recorded the immunosuppressant blood levels as a direct method.
The mean age of the patients was 50 ± 12 years, and 84% were male. According to the Morisky-Green test, 33% of the patients were noncompliant, of whom 30% said they rarely forgot to take their medication. Patients took an average of 8 ± 3 drugs per day, but only 85% knew what the drugs were for; 24% of the patients had grade 3A rejection, and 65% had graft vessel disease.
Transplanted patients in this study showed a high level of therapeutic adherence that did not differ from other transplant series, either cardiac or other organs, nor from other chronic diseases. The results for defaulters were higher than that expected from these patients. The defaulter results were expected to be lower, given the information that the patients were supposed to have, both before and after the transplantation, and with the strict medical monitoring. Therefore, we have to stress therapeutic compliance, both medical and dietary-hygiene measures, and seek new strategies to improve the results.
心脏移植患者需要终身服药，包括预防排斥反应的免疫抑制剂以及治疗其他疾病所需的药物。治疗依从性可通过定量或定性方式进行衡量。由于多种因素，依从性测量并非易事。本研究旨在评估心脏移植患者的治疗依从性患病率。
我们开展了一项横断面观察性描述性研究。样本包括2001年至2011年接受心脏移植的患者。在总共203名患者中，我们研究了99名。我们使用Morisky - Green测试作为间接方法，并记录免疫抑制剂血药浓度作为直接方法。
患者的平均年龄为50±12岁，84%为男性。根据Morisky - Green测试，33%的患者不依从，其中30%表示他们很少忘记服药。患者平均每天服用8±3种药物，但只有85%知道这些药物的用途；24%的患者发生3A级排斥反应，65%患有移植血管疾病。
本研究中的移植患者表现出较高的治疗依从性，这与其他心脏或其他器官移植系列以及其他慢性疾病的情况并无差异。不依从者的比例高于预期。鉴于患者在移植前后本应掌握的信息以及严格的医疗监测，不依从者的比例本应更低。因此，我们必须强调治疗依从性，包括医疗和饮食卫生措施，并寻求新的策略来改善结果。
