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肝移植后免疫抑制治疗的依从性:一项综合综述。

Adherence to immunosuppressive therapy following liver transplantation: an integrative review.

作者信息

Oliveira Ramon Antônio, Turrini Ruth Natália Teresa, Poveda Vanessa de Brito

机构信息

Master's Student, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.

PhD, Associate Professor, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil.

出版信息

Rev Lat Am Enfermagem. 2016 Aug 29;24:e2778. doi: 10.1590/1518-8345.1072.2778.

Abstract

OBJECTIVE

to investigate the evidence available in the literature on non-adherence to immunosuppressive therapy among patients undergoing liver transplantation.

METHOD

integrative literature review, including research whose sample consisted of patients aged over 18 years undergoing liver transplantation. It excluded those containing patients undergoing multiple organ transplants. For the selection of articles, Medline / Pubmed, CINAHL, LILACS, Scopus and Embase were searched. The search period corresponded to the initial date of indexation of different bases, up to the deadline of February 10, 2015, using controlled and uncontrolled descriptors: liver transplantation, hepatic transplantation, liver orthotopic transplantation, medication adherence, medication non-adherence, medication compliance and patient compliance.

RESULTS

were located 191 investigations, 10 of which met the objectives of the study and were grouped into four categories, namely: educational process and non-adherence; non-adherence related to the number of daily doses of immunosuppressive medications; detection methods for non-adherence and side effects of therapy.

CONCLUSION

there were risk factors related to the health service, such as control and reduction of the number of doses; related to the individual, such as being male, divorced, alcohol or other substances user, exposed to low social support and being mentally ill.

摘要

目的

调查文献中关于肝移植患者免疫抑制治疗依从性差的现有证据。

方法

综合文献综述,纳入样本为18岁以上肝移植患者的研究。排除包含多器官移植患者的研究。为筛选文章,检索了Medline / Pubmed、CINAHL、LILACS、Scopus和Embase。检索时间段为不同数据库的初始收录日期至2015年2月10日截止,使用了受控和非受控描述词:肝移植、肝移植术、原位肝移植、药物依从性、药物不依从性、药物顺应性和患者顺应性。

结果

共找到191项研究,其中10项符合研究目的,并分为四类,即:教育过程与不依从性;与免疫抑制药物每日剂量数量相关的不依从性;不依从性的检测方法及治疗副作用。

结论

存在与医疗服务相关的危险因素,如控制和减少剂量;与个体相关的危险因素,如男性、离异、使用酒精或其他物质、社会支持度低及患有精神疾病。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1ba0/5016054/ffd92892aef7/0104-1169-rlae-24-02778-gf1.jpg

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