Center for Translational Science, Children's National Medical Center, 111 Michigan Avenue Northwest, 5th Floor Main, Suite 5500, Office 5533, Washington, DC 20010, USA.
Clinical Psychology, Department of Psychology, Fordham University, 441 East Fordham Road, Dealy Hall, Bronx, NY 10458, USA.
Gastroenterol Clin North Am. 2018 Dec;47(4):939-948. doi: 10.1016/j.gtc.2018.07.015. Epub 2018 Sep 28.
Stable intake of an immunosuppressant medication regimen is essential for posttransplant survival in the vast majority of cases. And yet, many patients are nonadherent (do not take their medications as prescribed), and suffer consequences ranging from rejection to morbidity and mortality. We review the evidence related to monitoring of adherence to medications, and intervention strategies. Our aim is to provide a baseline from which readers may approach behavioral aspects of posttransplant care. This review may also help readers in designing clinical programs for routine monitoring of adherence, and inform the choice of intervention when adherence falls below a certain threshold.
在绝大多数情况下,稳定摄入免疫抑制剂药物方案对于移植后的存活至关重要。然而,许多患者不遵守医嘱(未按规定服用药物),并因此遭受各种后果,从排斥反应到发病和死亡。我们回顾了与监测药物依从性和干预策略相关的证据。我们的目的是提供一个基线,以便读者可以探讨移植后护理的行为方面。本综述还可以帮助读者设计常规监测依从性的临床方案,并在依从性低于一定阈值时为干预措施的选择提供信息。