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异基因造血细胞移植后成年和儿科受者的药物不依从性:由法语骨髓移植和细胞治疗学会进行的横断面研究。

Medication non-adherence after allogeneic hematopoietic cell transplantation in adult and pediatric recipients: a cross sectional study conducted by the Francophone Society of Bone Marrow Transplantation and Cellular Therapy.

机构信息

Institut de Pharmacie, CHU Lille, Lille, F-59000, France.

EA 2694 - Santé publique: épidémiologie et qualité des soins, CHU Lille, Univ. Lille, Lille, F-59000, France.

出版信息

Fundam Clin Pharmacol. 2021 Apr;35(2):435-445. doi: 10.1111/fcp.12593. Epub 2021 Jan 7.

DOI:10.1111/fcp.12593
PMID:32740936
Abstract

Medication non-adherence (NA) after allogeneic hematopoietic cell transplantation (allo-HCT) can lead to serious complications. This study assesses NA in French adult and pediatric recipients and identifies factors associated with NA. In accordance with the EMERGE and STROBE guidelines, a cross sectional multicentric survey was conducted. We used a self-reported questionnaire that was adapted to adults and pediatrics and that could provide a picture of all three phases of medication adherence: initiation, implementation, persistence. We enrolled 242 patients, 203 adults (mean age: 51 years old, 50.7% male) and 39 children (mean age: 9 years old, 56.4% female). Reported NA was estimated at about 75% in both populations, adults and pediatrics. In adults, the univariate analysis showed that patients less than 50 years old (P = 0.041), (i) treated with cyclosporine (P = 0.02), (ii) treated with valacyclovir/acyclovir (P = 0.016), and (iii) experiencing side effects (P = 0.009), were significantly more non-adherent. In multivariate analysis, only recipient age was significantly associated to NA (P = 0.05). The limited size of the pediatric population did not allow us to draw any statistical conclusion about this population. To the best of our knowledge, this is the first study in France on NA in allo-HCT recipients. Our results highlight the age factor as the only factor related to NA. Further studies are needed to confirm our observations and refine results in pediatric populations, currently most at risk of medication NA.

摘要

异基因造血细胞移植(allo-HCT)后药物不依从(NA)可导致严重并发症。本研究评估了法国成年和儿科受者的 NA,并确定了与 NA 相关的因素。根据 EMERGE 和 STROBE 指南,进行了一项横断面多中心调查。我们使用了一份自我报告的问卷,该问卷适用于成人和儿科患者,并能提供药物依从性三个阶段的全貌:起始、实施、持续。我们共纳入 242 例患者,203 例成年患者(平均年龄:51 岁,50.7%为男性)和 39 例儿童(平均年龄:9 岁,56.4%为女性)。在成年患者和儿科患者中,报告的 NA 发生率均约为 75%。在成年患者中,单因素分析显示,年龄小于 50 岁的患者(P=0.041):(i) 接受环孢素治疗(P=0.02),(ii) 接受伐昔洛韦/阿昔洛韦治疗(P=0.016),和 (iii) 出现副作用(P=0.009),明显更不依从。多因素分析显示,只有受者年龄与 NA 显著相关(P=0.05)。儿科患者人数有限,无法对该人群得出任何统计学结论。据我们所知,这是法国 allo-HCT 受者中关于 NA 的第一项研究。我们的结果强调了年龄因素是与 NA 相关的唯一因素。需要进一步的研究来证实我们的观察结果,并细化儿科人群的结果,目前儿科人群最容易出现药物 NA。

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