Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.
Renal Unit, Department of Medicine, Queen Elizabeth Hospital, Hong Kong SAR, China.
Transplant Proc. 2021 Oct;53(8):2447-2450. doi: 10.1016/j.transproceed.2021.08.018. Epub 2021 Aug 16.
The coronavirus disease 2019 (COVID-19) pandemic has put an enormous burden on health care systems worldwide. Limited access to medical care and fear of increased infective risks due to the use of immunosuppressive medication (IM) have increased concerns about IM adherence in kidney transplant recipients (KTRs). The aim of this study was to determine the various dimensions of IM nonadherence in KTRs during the COVID-19 pandemic.
This was a single-center, cross-sectional study using a convenient sampling approach. KTRs with follow-up in Queen Elizabeth Hospital, Hong Kong between May 1, 2020 and September 30, 2020, were invited to complete a self-reported questionnaire on IM adherence. The sociodemographic factors associated with IM adherence were extracted from medical records.
Overall, 210 patients completed the questionnaires. The overall IM nonadherence rate was 35.2% in the 4 weeks before survey completion. None of the patients stopped taking IMs without instructions from their health care providers. The most common pattern of IM nonadherence was timing adherence (n = 63; 30.1%), followed by dose-skipping item. Among the different sociodemographic factors studied, only marital status was an independent risk factor of IM nonadherence (odds ratio, 1.97; 95% confidence interval, 1.04-3.72; P = .03).
The impact of COVID-19 on IM adherence in KTRs was not significant. All the patients continued their IM despite of the pandemic. Good family support can have a positive influence on treatment adherence in KTRs during the COVID-19 pandemic.
2019 年冠状病毒病（COVID-19）大流行给全球医疗系统带来了巨大负担。由于获得医疗服务的机会有限，以及因使用免疫抑制药物（IM）而担心感染风险增加，人们越来越关注肾移植受者（KTR）的 IM 依从性。本研究旨在确定 COVID-19 大流行期间 KTR 中 IM 不依从的各个方面。
这是一项单中心、横断面研究，采用便利抽样方法。邀请 2020 年 5 月 1 日至 2020 年 9 月 30 日期间在香港伊利沙伯医院接受随访的 KTR 完成一份关于 IM 依从性的自我报告问卷。从病历中提取与 IM 依从性相关的社会人口学因素。
共有 210 名患者完成了问卷。在调查完成前的 4 周内，总体 IM 不依从率为 35.2%。没有患者在没有医疗保健提供者指示的情况下停止服用 IM。最常见的 IM 不依从模式是时间依从性（n=63；30.1%），其次是剂量跳过项目。在所研究的不同社会人口学因素中，只有婚姻状况是 IM 不依从的独立危险因素（优势比，1.97；95%置信区间，1.04-3.72；P=0.03）。
COVID-19 对 KTRs 的 IM 依从性没有显著影响。尽管大流行，所有患者都继续服用 IM。在 COVID-19 大流行期间，良好的家庭支持可能对 KTR 的治疗依从性产生积极影响。
