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评估患者教育与访谈对提高肾移植受者用药依从性的有效性

Assessment of the Effectiveness of Patient Education and Interviews in Improving Medication Adherence of Renal Transplant Recipients.

作者信息

Akşit Naile, Özbaş Ayfer, Akıncı Serkan

机构信息

Health Sciences, Fenerbahçe University, Istanbul, TUR.

Nursing, Istanbul University, Istanbul, TUR.

出版信息

Cureus. 2022 Dec 27;14(12):e33010. doi: 10.7759/cureus.33010. eCollection 2022 Dec.

Abstract

Background Non-compliance with immunosuppressive drugs has been reported as the most significant cause of graft loss. Since non-compliance with immunosuppressive drugs is preventable, certain approaches based on the risk factors and causes of non-compliance can help eliminate this problem. Aims The purpose of this study is to assess the effectiveness of patient education and interviews in improving medication adherence of renal-transplant recipients. Materials and methods This study was designed as a randomized controlled trial. Using the G*Power program, the sample size was calculated as 60 subjects, with 30 in both the intervention group and control group. Data collection tools included a patient information form, a pretest-posttest, a drug monitoring form for kidney transplant patients, the Immunosuppressive Therapy Adherence Scale, measurement of tacrolimus blood levels, and a training booklet.  Results The mean knowledge score in the intervention group was 12.17±3.39 at baseline, and it increased to 20.73±1.57 after the intervention. The mean scores on the Immunosuppressant Therapy Adherence Scale were 11.67±0.55 and 10.70±0.99 in the intervention group and control group, respectively. There was a statistically significant difference between the pre-test and post-test means on the Immunosuppressant Therapy Adherence Scale in the intervention group. The mean Immunosuppressant Therapy Adherence Scale score was higher in the intervention group. In the measurement of tacrolimus blood levels, medication adherence was found the be higher in the intervention group. The difference between the groups was statistically significant. There was a positive correlation between the tacrolimus blood levels and the Immunosuppressant Therapy Adherence Scale scores in both groups. Conclusions To conclude, our results have demonstrated that patient education and interviews improve immunosuppressant medication adherence in renal transplant recipients. Using direct or indirect methods proved similar outcomes, suggesting that both evaluation methods are safe.

摘要

背景

据报道,不遵守免疫抑制药物治疗是移植物丢失的最主要原因。由于不遵守免疫抑制药物治疗是可以预防的,基于不遵守治疗的风险因素和原因采取的某些方法有助于消除这一问题。目的:本研究旨在评估患者教育和访谈对提高肾移植受者药物依从性的有效性。材料和方法:本研究设计为随机对照试验。使用G*Power程序计算样本量为60名受试者,干预组和对照组各30名。数据收集工具包括患者信息表、前测-后测、肾移植患者药物监测表、免疫抑制治疗依从性量表、他克莫司血药浓度测定以及一本培训手册。结果:干预组基线时的平均知识得分是12.17±3.39,干预后增至20.73±1.57。免疫抑制治疗依从性量表的平均得分在干预组和对照组分别为11.67±0.55和10.70±0.99。干预组免疫抑制治疗依从性量表的前测和后测均值之间存在统计学显著差异。干预组免疫抑制治疗依从性量表的平均得分更高。在他克莫司血药浓度测定中,发现干预组的药物依从性更高。两组之间的差异具有统计学显著性。两组中他克莫司血药浓度与免疫抑制治疗依从性量表得分之间均呈正相关。结论:总之,我们的结果表明患者教育和访谈可提高肾移植受者免疫抑制药物的依从性。使用直接或间接方法证明了相似的结果,表明这两种评估方法都是安全的。

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