College of Pharmacy and Nutrition, 70398University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Multi-Organ Transplant Program, Toronto General Hospital, 7989University Health Network, Toronto, Ontario, Canada.
Prog Transplant. 2020 Sep;30(3):254-264. doi: 10.1177/1526924820933821. Epub 2020 Jun 29.
Adverse symptoms experienced by solid organ transplant recipients remain largely unexplored despite their purported frequency.
To characterize patient perspectives on adverse symptoms, identifying the most problematic symptoms and the perceived cause and treatability, and to evaluate their impact on quality of life (QoL) and medication adherence.
An electronic survey was distributed to members of the Canadian Transplant Association, to characterize perceptions on symptom experience (Modified Transplant Symptom Occurrence and Distress Scale), and QoL (Short Form-12), medication adherence (Basel Assessment of Adherence to Immunosuppressive Medications Scale), demographics, and clinical situation.
The questionnaire was distributed to 249 solid organ transplant recipients and achieved a 51% response rate (N = 127). Respondents reported a mean of 25 (standard deviation 10) adverse symptoms each. In women, the most prevalent and distressing symptoms were tiredness, lack of energy, sleep difficulties, difficulty concentrating or memory problems, diarrhea, joint pain, and depression. In men, they were tiredness, flatulence, lack of energy, sleep difficulties, and erectile problems. With the exception of flatulence, these symptoms were more often perceived to be caused by medical conditions rather than by immunosuppressants or other medications. Quality of life was similar to the general public, with mean physical and mental component scores of 47.4 (9.9) and 52.1 (8.2), respectively (relative to a US average of 50 [10]). However, QoL scores inversely correlated to the number of symptoms reported and were higher in patients who perceived all symptoms to be treatable.
Adverse symptoms may impact patient well-being. Perceived cause and treatability should be further explored.
尽管实体器官移植受者出现的不良反应症状据称很常见,但目前仍大多未被探索。
从患者的角度来描述不良反应症状,确定最常见的问题症状以及他们感知到的病因和可治疗性,并评估其对生活质量(QoL)和药物依从性的影响。
通过电子问卷调查了加拿大移植协会的成员,以了解他们对症状体验(改良移植症状发生和困扰量表)和 QoL(短表 12)、药物依从性(巴塞尔免疫抑制药物依从性评估量表)、人口统计学和临床情况的看法。
该问卷分发给 249 名实体器官移植受者,响应率为 51%(N=127)。受访者报告平均有 25 种(标准差 10)不良反应症状。在女性中,最常见和最困扰的症状是疲倦、乏力、睡眠困难、注意力不集中或记忆力问题、腹泻、关节痛和抑郁。在男性中,最常见的是疲倦、肠胃气胀、乏力、睡眠困难和勃起功能障碍。除了肠胃气胀,这些症状更常被认为是由疾病引起的,而不是由免疫抑制剂或其他药物引起的。生活质量与普通人群相似,身体和精神成分的平均得分为 47.4(9.9)和 52.1(8.2)(相对于美国的平均水平 50[10])。然而,QoL 评分与报告的症状数量呈负相关,并且那些认为所有症状都可治疗的患者的 QoL 评分更高。
不良反应症状可能会影响患者的健康幸福感。应进一步探讨感知到的病因和可治疗性。