心脏移植受者中合并用药与免疫抑制剂相比药物不依从的流行率：来自国际横断面 BRIGHT 研究的结果。
Prevalence of Medication Nonadherence to Co-medication Compared to Immunosuppressants in Heart Transplant Recipients: Findings From the International Cross-sectional BRIGHT Study.
机构信息
Institute of Nursing Science, Department Public Health, Faculty of Medicine, University of Basel, Basel, Switzerland.
Hospital Municipal Vila Santa Catarina - Ministério da Saúde PROADI-SUS, São Paulo, Brazil; School of Nursing, Federal University of São Paulo, São Paolo, Brazil.
出版信息
Clin Ther. 2019 Jan;41(1):130-136. doi: 10.1016/j.clinthera.2018.11.007. Epub 2018 Dec 24.
PURPOSE
To assess and compare the prevalence of medication nonadherence (MNA) (implementation and persistence) to immunosuppressants and co-medications in heart transplant recipients.
METHODS
MNA prevalence was assessed using the Basel Assessment of Adherence to Immunosuppressive Medications Scale (self-report) and compared using logistic regression in a 4-continent sample of 1397 heart transplant recipients from 36 heart transplant centers in 11 countries.
FINDINGS
MNA was significantly (α = 0.05) higher to co-medications than to immunosuppressants (taking nonadherence: 23.9% vs 17.3%; odds ratio [OR] = 1.5; 95% CI, 1.30-1.73; drug holiday: 5.7% vs 1.9%; OR = 3.17; 95% CI, 2.13-4.73; dose alteration: 3.8% vs 1.6%; OR = 2.46; 95% CI, 1.49-4.06; and discontinuation: 2.6% vs 0.5%; OR = 5.15; 95% CI, 2.36-11.20).
IMPLICATIONS
The observed MNA necessitates adherence-enhancing interventions encompassing the entire post-heart transplant medication regimen. ClinicalTrials.gov identifier: NCT01608477.
目的
评估和比较心脏移植受者免疫抑制剂和合并用药的用药不依从（MNA）（执行和坚持）的发生率。
方法
使用巴塞尔评估免疫抑制药物依从性量表（自我报告）评估 MNA 的发生率，并在来自 11 个国家的 36 个心脏移植中心的 1397 名心脏移植受者的 4 大洲样本中使用逻辑回归进行比较。
发现
与免疫抑制剂相比，合并用药的 MNA 显著更高（不依从：23.9%比 17.3%；比值比[OR]为 1.5；95%可信区间，1.30-1.73；药物假期：5.7%比 1.9%；OR 为 3.17；95%可信区间，2.13-4.73；剂量调整：3.8%比 1.6%；OR 为 2.46；95%可信区间，1.49-4.06；停药：2.6%比 0.5%；OR 为 5.15；95%可信区间，2.36-11.20）。
意义
观察到的 MNA 需要包含整个心脏移植后药物治疗方案的增强依从性干预措施。临床试验注册号：NCT01608477。
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