肝移植受者的免疫抑制药物依从性
Immunosuppressive Medication Adherence in Liver Transplant Recipients.
作者信息
Promraj R, Dumronggittigule W, Sirivatanauksorn Y, Ruenrom A, Tovikkai C, Limsrichamrern S, Kositamongkol P, Mahawithitwong P, Asavakarn S
机构信息
Ambulatory Care Unit, Pharmacy Department, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Hepatopancreatobiliary and Transplant Surgery Unit, Division of General Surgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
出版信息
Transplant Proc. 2016 May;48(4):1198-201. doi: 10.1016/j.transproceed.2015.12.097.
BACKGROUND
Immunosuppressive medication is one of the pivotal factors in the outcome of liver transplant patients. Nonadherence to immunosuppressive therapy is a common problem after transplantation and affects graft and patient survival. This study aimed to assess immunosuppressive medication adherence in liver transplant recipients.
METHODS
Liver transplant recipients who underwent the Siriraj-Support Medication Adherence in Organ Transplantation (S-SMAOT) program were included in this cross-sectional study. Immunosuppressive medication adherence was assessed with the use of the Immunosuppressive Therapy Adherence Scale (ITAS, which is scored from 0 to 12; very poor to excellence adherence). The correlations between ITAS scores and the clinical profiles of the patients, duration after transplantation, and transplant educational scores post-test were also analyzed.
RESULTS
From October 2012 to September 2014, a total of 50 liver transplant recipients (86 visits) were enrolled in this study. The ratio of male to female patients was 48:52. The proportions of patients with ITAS scores of 12, 10-11, and 0-9 were 82.6%, 16.3% and 1.2%, respectively. ITAS score was significantly correlated with the duration after transplantation (P < .001) and the educational scores (P = .009).
CONCLUSIONS
Consistent assessment of patients' immunosuppressive medication adherence is essential to avoid problems of noncompliance and to improve the outcome after liver transplantation. The S-SMAOT program was an effective approach to significantly improve the medication adherence in liver transplant recipients.
背景
免疫抑制药物是肝移植患者预后的关键因素之一。移植后不坚持免疫抑制治疗是一个常见问题，会影响移植物和患者的存活。本研究旨在评估肝移植受者的免疫抑制药物依从性。
方法
本横断面研究纳入了参加诗里拉吉器官移植支持药物依从性（S-SMAOT）项目的肝移植受者。使用免疫抑制治疗依从性量表（ITAS，评分范围为0至12分；依从性从非常差到优秀）评估免疫抑制药物依从性。还分析了ITAS评分与患者临床特征、移植后时间以及测试后移植教育得分之间的相关性。
结果
2012年10月至2014年9月，共有50名肝移植受者（86次就诊）纳入本研究。男女患者比例为48:52。ITAS评分为12分、10 - 11分和0 - 9分的患者比例分别为82.6%、16.3%和1.2%。ITAS评分与移植后时间（P <.001）和教育得分（P =.009）显著相关。
结论
持续评估患者的免疫抑制药物依从性对于避免不依从问题和改善肝移植后的预后至关重要。S-SMAOT项目是显著提高肝移植受者药物依从性的有效方法。
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