Brocks Y, Zittermann A, Grisse D, Schmid-Ott G, Stock-Gießendanner S, Schulz U, Brakhage J, Benkler A, Gummert J, Tigges-Limmer Katharina
1 Clinic for Thoracic and Cardiovascular Surgery, Heart and Diabetes Center North Rhine-Westphalia, Ruhr-University Bochum, Bad Oeynhausen, Germany.
2 Berolina Clinic, Löhne, Germany.
Prog Transplant. 2017 Jun;27(2):160-166. doi: 10.1177/1526924817699959. Epub 2017 Mar 22.
Nonadherence may cause severe health problems in heart transplant (HTx) recipients.
The present study aimed to investigate adherence to prescribed medication and recommended lifestyle habits in post-HTx patients and to assess associations between adherence, quality of life (QOL), and psychological well-being.
A questionnaire package was sent to all HTx patients from our clinic (n = 858) to answer questions anonymously on medication adherence, dietary recommendations (avoidance of raw animal products and ice cream), pet keeping (risk of zoonosis), anxiety and depression, QOL, and posttraumatic stress disorders.
Of the contacted patients, 524 (61%) responded and 505 fulfilled the inclusion criteria (age ≥18 years and ability to understand German). Of the study participants, 72.4% reported taking their medications very correctly, 72.2% stated consuming alcohol less often than once a week, 58.3% performed physical exercise at least once a week, one-third reported eating nonrecommended foods, 22.1% stated pet keeping, and 4.3% reported smoking. Adherence to prescribed medication was positively associated with age ( P < .001) and mental QOL ( P = .015) but was unrelated to eating nonrecommended foods ( P > .05). Depressiveness correlated inversely with physical QOL ( r = -0.232; P < .01) and mental QOL ( r = -0.411; P < .01). Stress disorders and minor stressful events were reported by 7.8% and 46.6%, respectively. Stress disorders correlated inversely with mental QOL ( r = -0.282; P < .01) and physical QOL ( r = -0.422; P < .01).
Many HTx patients adhere to prescribed medications and health advice. Nevertheless, nonadherence is a problem, especially in younger HTx patients, indicating the need for a nonadherence crisis intervention program for long-term HTx patients.
不依从医嘱可能会给心脏移植（HTx）受者带来严重的健康问题。
本研究旨在调查HTx术后患者对规定药物治疗和推荐生活方式的依从性，并评估依从性、生活质量（QOL）和心理健康之间的关联。
向我们诊所的所有HTx患者（n = 858）发送了一套问卷，让他们匿名回答有关药物依从性、饮食建议（避免食用生动物制品和冰淇淋）、饲养宠物（人畜共患病风险）、焦虑和抑郁、生活质量以及创伤后应激障碍的问题。
在被联系的患者中，524名（61%）做出了回应，505名符合纳入标准（年龄≥18岁且具备理解德语的能力）。在研究参与者中，72.4%的人报告说他们非常正确地服用药物，72.2%的人表示饮酒频率低于每周一次，58.3%的人每周至少进行一次体育锻炼，三分之一的人报告食用了不推荐的食物，22.1%的人表示饲养宠物，4.3%的人报告吸烟。对规定药物的依从性与年龄呈正相关（P < .001）和心理生活质量呈正相关（P = .015），但与食用不推荐食物无关（P > .05）。抑郁程度与身体生活质量呈负相关（r = -0.232；P < .01）和心理生活质量呈负相关（r = -0.411；P < .01）。分别有7.8%和46.6%的人报告有应激障碍和轻微应激事件。应激障碍与心理生活质量呈负相关（r = -0.282；P < .01）和身体生活质量呈负相关（r = -0.422；P < .01）。
许多HTx患者遵守规定的药物治疗和健康建议。然而，不依从是一个问题，尤其是在年轻的HTx患者中，这表明需要为长期HTx患者制定一个不依从危机干预计划。
