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肾移植受者的药物依从性和治疗满意度

Medication Adherence and Treatment Satisfaction Among Renal Transplant Recipients.

作者信息

Alkatheri Abdulmalik A, Albekairy Abdulkareem M, Jarab Anan, Bustami Rami, Khalidi Nabil, Alshaya Abdulrahman, Bin Saleh Khalid, Alraddadi Sultan, Alharbi Shmeylan, Vasudevan Senthilvel, Alsayyari Abdullah, Qandil Amjad M

机构信息

Department of Pharmacy Practice, College of Pharmacy, King Saud bin Abdulaziz University for Health Sciences, Ministry National Guard Health Affairs, Riyadh, Saudi Arabia.

Department of Pharmaceutical Care, King Abdulaziz Medical City, Ministry National Guard Health Affairs, Riyadh, Saudi Arabia.

出版信息

Ann Transplant. 2016 May 5;21:270-8. doi: 10.12659/aot.897101.

Abstract

BACKGROUND Evidence suggests that patients who are more satisfied with their treatment show better adherence with the prescribed therapy. Although there is valuable data about medication adherence among renal transplant recipients (RTRs), there is a limited literature about their treatment satisfaction and its relation to adherence. The aim of the present study was to investigate factors that can predict medication adherence and to explore the relationship between treatment satisfaction and medication adherence in renal transplant recipients. MATERIAL AND METHODS Adult RTRs were included in the study using convenient sampling. The participants were asked to complete the 8-item Morisky Medication Adherence Scale (MMAS-8) and Treatment Satisfaction Scale TSQM 1.4 in addition to several socio-demographic and treatment-related data. The results were statistically analyzed using univariate and multivariate logistic regression modelling in a stepwise procedure. RESULTS A total of 151 RTRs were included in the study, of which 52 were classified as adherent (34%). Univariate analysis showed that, in comparison with non-adherent RTRs, the adherent group demonstrated significantly higher satisfaction scores in the domains of convenience (96.6±8.7 vs. 85.3±19.3), side effects (95.9±14.1 vs. 82.6±24.1), and global satisfaction (93.4±9.8 vs. 86.7±16.7), while they had marginally higher satisfaction scores in the effectiveness domain (90.4±11.6 vs. 86.5±14.5). Results from multiple logistic regression showed that higher likelihood of adherence was significantly associated with increased satisfaction score in the convenience domain [AOR=1.76, 95% CI=(1.21, 2.55); p=0.003] and marginally related to increased satisfaction scores in the side effects domain [AOR=1.31, 95% CI=(0.99, 1.74); p=0.061]. Male RTRs were significantly more likely to be adherent than female RTRs [AOR=2.23, 95% CI=(1.02, 4.84); p=0.043]. CONCLUSIONS Although the adherence rate among RTRs is relatively low, males and RTRs who reported higher treatment satisfaction (convenience and side effects domains) showed better medication adherence. It is recommended that interventional programs for the improvement of dialysis patient adherence should be developed, in addition to designing strategies to improve treatment convenience and knowledge of medication side effects.

摘要

背景 有证据表明,对治疗更满意的患者对规定治疗的依从性更好。虽然有关于肾移植受者(RTR)药物依从性的宝贵数据,但关于他们的治疗满意度及其与依从性的关系的文献有限。本研究的目的是调查可预测药物依从性的因素,并探讨肾移植受者的治疗满意度与药物依从性之间的关系。

材料与方法 采用便利抽样法将成年RTR纳入研究。除了一些社会人口统计学和治疗相关数据外,参与者还被要求完成8项Morisky药物依从性量表(MMAS-8)和治疗满意度量表TSQM 1.4。采用单因素和多因素逻辑回归模型逐步进行统计分析。

结果 本研究共纳入151名RTR,其中52名被归类为依从者(34%)。单因素分析显示,与不依从的RTR相比,依从组在便利性(96.6±8.7对85.3±19.3)、副作用(95.9±14.1对82.6±24.1)和总体满意度(93.4±9.8对86.7±16.7)方面的满意度得分显著更高,而在有效性方面的满意度得分略高(90.4±11.6对86.5±14.5)。多因素逻辑回归结果显示,依从可能性更高与便利性方面的满意度得分增加显著相关[AOR=1.76,95%CI=(1.21,2.55);p=0.003],与副作用方面的满意度得分增加略有相关[AOR=1.31,95%CI=(0.99,1.74);p=0.061]。男性RTR比女性RTR更有可能依从[AOR=2.23,95%CI=(1.02,4.84);p=0.043]。

结论 虽然RTR的依从率相对较低,但男性和报告治疗满意度较高(便利性和副作用方面)的RTR药物依从性更好。建议除了设计提高治疗便利性和药物副作用知识的策略外,还应制定改善透析患者依从性的干预方案。

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